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Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: long-term results for patients treated according to the Rizzoli IOR/OS-3b protocol.
J Chemother 2001; 13(1):93-9JC

Abstract

The results of the Rizzoli IOR/OS-3b neoadjuvant protocol for the treatment of osteosarcoma of the extremity are reported. Preoperative chemotherapy consisted of two cycles of high-dose methotrexate (HDMTX i.v.), followed by a combination of cisplatin (CDP i.a.)/ doxorubicin (ADM i.v.). Postoperatively all patients, regardless of the histologic response, received 3 more cycles of MTX, CDP/ADM alternated with 3 cycles of ifosfamide. In the study performed between January and December 1992 43 patients were enrolled and limb salvage was performed in 39 of them (91%). The histologic response to chemotherapy was good (90% or more tumor necrosis) in 24 patients (56%) and poor (less than 90% tumor necrosis) in 19 (44%). With a minimum follow-up of 7 years, 23 pts (53%) remained continuously free of disease, 19 relapsed and one died due to unrelated cause. In spite of the high number of limb salvages performed, only 2 local recurrences were registered. The 7-year event-free survival and overall survival were, respectively, 53% and 68%. The hematopoietic and extrahematopoietic toxicity experienced by the patients during the entire treatment was relatively mild. These long-term results confirm that, with neoadjuvant chemotherapy, it is possible to cure more than 60% of patients with osteosarcoma of the extremities, avoiding amputation in most of them. These results, however, are no better than those achieved in our previous study IOR/OS-3a, in which only poor responder patients received ifosfamide during the postoperative treatment.

Authors+Show Affiliations

Chemotherapy Division, Istituto Ortopedico Rizzoli, Bologna, Italy. gaetano.bacci@ior.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11233808

Citation

Bacci, G, et al. "Neoadjuvant Chemotherapy for High Grade Osteosarcoma of the Extremities: Long-term Results for Patients Treated According to the Rizzoli IOR/OS-3b Protocol." Journal of Chemotherapy (Florence, Italy), vol. 13, no. 1, 2001, pp. 93-9.
Bacci G, Ferrari S, Longhi A, et al. Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: long-term results for patients treated according to the Rizzoli IOR/OS-3b protocol. J Chemother. 2001;13(1):93-9.
Bacci, G., Ferrari, S., Longhi, A., Forni, C., Bertoni, F., Fabbri, N., ... Versari, M. (2001). Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: long-term results for patients treated according to the Rizzoli IOR/OS-3b protocol. Journal of Chemotherapy (Florence, Italy), 13(1), pp. 93-9.
Bacci G, et al. Neoadjuvant Chemotherapy for High Grade Osteosarcoma of the Extremities: Long-term Results for Patients Treated According to the Rizzoli IOR/OS-3b Protocol. J Chemother. 2001;13(1):93-9. PubMed PMID: 11233808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: long-term results for patients treated according to the Rizzoli IOR/OS-3b protocol. AU - Bacci,G, AU - Ferrari,S, AU - Longhi,A, AU - Forni,C, AU - Bertoni,F, AU - Fabbri,N, AU - Zavatta,M, AU - Versari,M, PY - 2001/3/10/pubmed PY - 2001/6/29/medline PY - 2001/3/10/entrez SP - 93 EP - 9 JF - Journal of chemotherapy (Florence, Italy) JO - J Chemother VL - 13 IS - 1 N2 - The results of the Rizzoli IOR/OS-3b neoadjuvant protocol for the treatment of osteosarcoma of the extremity are reported. Preoperative chemotherapy consisted of two cycles of high-dose methotrexate (HDMTX i.v.), followed by a combination of cisplatin (CDP i.a.)/ doxorubicin (ADM i.v.). Postoperatively all patients, regardless of the histologic response, received 3 more cycles of MTX, CDP/ADM alternated with 3 cycles of ifosfamide. In the study performed between January and December 1992 43 patients were enrolled and limb salvage was performed in 39 of them (91%). The histologic response to chemotherapy was good (90% or more tumor necrosis) in 24 patients (56%) and poor (less than 90% tumor necrosis) in 19 (44%). With a minimum follow-up of 7 years, 23 pts (53%) remained continuously free of disease, 19 relapsed and one died due to unrelated cause. In spite of the high number of limb salvages performed, only 2 local recurrences were registered. The 7-year event-free survival and overall survival were, respectively, 53% and 68%. The hematopoietic and extrahematopoietic toxicity experienced by the patients during the entire treatment was relatively mild. These long-term results confirm that, with neoadjuvant chemotherapy, it is possible to cure more than 60% of patients with osteosarcoma of the extremities, avoiding amputation in most of them. These results, however, are no better than those achieved in our previous study IOR/OS-3a, in which only poor responder patients received ifosfamide during the postoperative treatment. SN - 1120-009X UR - https://www.unboundmedicine.com/medline/citation/11233808/Neoadjuvant_chemotherapy_for_high_grade_osteosarcoma_of_the_extremities:_long_term_results_for_patients_treated_according_to_the_Rizzoli_IOR/OS_3b_protocol_ L2 - http://www.tandfonline.com/doi/full/10.1179/joc.2001.13.1.93 DB - PRIME DP - Unbound Medicine ER -