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Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases.
Int J Radiat Oncol Biol Phys 2007; 67(2):505-11IJ

Abstract

PURPOSE

Evaluate treatment and outcome of 20 patients with radioinduced osteosarcoma (RIO). Because of previous primary tumor treatment, RIO protocols were different from others we used for non-RIO.

PATIENTS AND METHODS

Between 1983 and 1998, we treated 20 RIO patients, ages 4-36 years (mean 16 years), with chemotherapy (two cycles before surgery, three postoperatively). The first preoperative cycle consisted of high-dose Methotrexate (HDMTX)/Cisplatinum (CDP)/Adriamycin (ADM) and the second of HDMTX/CDP/Ifosfamide (IFO). The three postoperative treatments were performed with cycles of MTX/CDP; IFO was used as single agent per cycle repeated three times.

RESULTS

Two patients received palliative treatment because their osteosarcoma remained unresectable after preoperative chemotherapy. The remaining 18 patients had surgery (7 amputations, 11 resections); histologic response to preoperative chemotherapy was good in 8 patients, poor in 10. At a mean follow-up of 11 years (range, 7-22 years), 9 patients remained continuously disease-free, 10 died from osteosarcoma and 1 died from a third neoplasm (myeloid acute leukemia). These results are not significantly different from those achieved in 754 patients with conventional osteosarcoma treated in the same period with protocols used for conventional treatment. However, this later group had an 18% 3-year event-free survival after treatment of relapse vs. 0% in the RIO group.

CONCLUSION

Treated with neoadjuvant chemotherapy RIO seem to have an outcome that is not significantly different from that of comparable patients with conventional primary high grade osteosarcoma (5-year event-free survival: 40% vs. 60%, p = NS; 5-year overall survival 40% vs. 67%, p < 0.01).

Authors+Show Affiliations

Sections of Chemotherapy, Istituti Ortopedici 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17118571

Citation

Bacci, Gaetano, et al. "Neoadjuvant Chemotherapy for Radioinduced Osteosarcoma of the Extremity: the Rizzoli Experience in 20 Cases." International Journal of Radiation Oncology, Biology, Physics, vol. 67, no. 2, 2007, pp. 505-11.
Bacci G, Longhi A, Forni C, et al. Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases. Int J Radiat Oncol Biol Phys. 2007;67(2):505-11.
Bacci, G., Longhi, A., Forni, C., Fabbri, N., Briccoli, A., Barbieri, E., ... Picci, P. (2007). Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases. International Journal of Radiation Oncology, Biology, Physics, 67(2), pp. 505-11.
Bacci G, et al. Neoadjuvant Chemotherapy for Radioinduced Osteosarcoma of the Extremity: the Rizzoli Experience in 20 Cases. Int J Radiat Oncol Biol Phys. 2007 Feb 1;67(2):505-11. PubMed PMID: 17118571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases. AU - Bacci,Gaetano, AU - Longhi,Alessandra, AU - Forni,Cristiana, AU - Fabbri,Nicola, AU - Briccoli,Antonio, AU - Barbieri,Enza, AU - Mercuri,Mario, AU - Balladelli,Alba, AU - Ferrari,Stefano, AU - Picci,Piero, Y1 - 2006/11/21/ PY - 2006/06/07/received PY - 2006/08/31/revised PY - 2006/08/31/accepted PY - 2006/11/23/pubmed PY - 2007/2/27/medline PY - 2006/11/23/entrez SP - 505 EP - 11 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 67 IS - 2 N2 - PURPOSE: Evaluate treatment and outcome of 20 patients with radioinduced osteosarcoma (RIO). Because of previous primary tumor treatment, RIO protocols were different from others we used for non-RIO. PATIENTS AND METHODS: Between 1983 and 1998, we treated 20 RIO patients, ages 4-36 years (mean 16 years), with chemotherapy (two cycles before surgery, three postoperatively). The first preoperative cycle consisted of high-dose Methotrexate (HDMTX)/Cisplatinum (CDP)/Adriamycin (ADM) and the second of HDMTX/CDP/Ifosfamide (IFO). The three postoperative treatments were performed with cycles of MTX/CDP; IFO was used as single agent per cycle repeated three times. RESULTS: Two patients received palliative treatment because their osteosarcoma remained unresectable after preoperative chemotherapy. The remaining 18 patients had surgery (7 amputations, 11 resections); histologic response to preoperative chemotherapy was good in 8 patients, poor in 10. At a mean follow-up of 11 years (range, 7-22 years), 9 patients remained continuously disease-free, 10 died from osteosarcoma and 1 died from a third neoplasm (myeloid acute leukemia). These results are not significantly different from those achieved in 754 patients with conventional osteosarcoma treated in the same period with protocols used for conventional treatment. However, this later group had an 18% 3-year event-free survival after treatment of relapse vs. 0% in the RIO group. CONCLUSION: Treated with neoadjuvant chemotherapy RIO seem to have an outcome that is not significantly different from that of comparable patients with conventional primary high grade osteosarcoma (5-year event-free survival: 40% vs. 60%, p = NS; 5-year overall survival 40% vs. 67%, p < 0.01). SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/17118571/Neoadjuvant_chemotherapy_for_radioinduced_osteosarcoma_of_the_extremity:_The_Rizzoli_experience_in_20_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(06)02961-0 DB - PRIME DP - Unbound Medicine ER -