Neoadjuvant chemotherapy with intraarterial doxorubicin and other systemic agents in the treatment of Stage II B osteosarcoma of the extremities

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We assessed the impact of two cycles of preoperative chemotherapy (OOS-B) with intraarterial doxorubicin (50mg/m2/day×2) plus intravenous cisplatin (100mg/m2) and high-dose methotrexate (300mg/kg) in 35 patients with stage II B osteosarcoma of the extremities who underwent limb-saving surgery. In 26 (74%) of the 35 patients, necrosis of over 90% of the tumor tissue was achieved by preoperative chemotherapy. The 5-year disease-free survival rate was 68.6%. Local recurrence developed in two patients (5.7%), one of whom had previously received inappropriate surgery. The 5-year continuously disease-free survival rate of good responders (>90% tumor necrosis) and poor responders (<90% tumor necrosis) was 80.8% and 33.3%, respectively, and the difference was statistically significant (P=0.003). There were no complications of intraarterial doxorubicin that were severe enough to influence the treatment program.These results suggest that preoperative chemotherapy with intraarterial doxorubicin combined with systemic adjuvant chemotherapy might improve outcome of osteosarcoma as well as making limb salvage safer and easier.
日本癌病態治療研究会の論文