Clinical analysis of Chinese limb osteosarcoma patients treated by two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide.

AIMS

The objective of this study was to investigate the efficacy and toxic side effects of two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide on treating Chinese osteosarcoma patients.

METHODS

A retrospective analysis was conducted of 185 osteosarcoma patients treated with the four drugs mentioned above. A total of 93 patients received the Italian therapeutic treatment (IOR-OS/N-5: Instituto Ortopedic Rizzoli-Section of Osteosacorma/Neoadjuvant chemotherapy-5) and the remaining 92 patients received the therapeutic treatment optimized by our department. We compared the efficacy and toxic side effects of these two therapies.

RESULTS

The limb salvage rates, 3-year recurrence rates and 3-year metastasis rates of IOR-OS/N-5 and our optimized treatment were 52.7 and 58.7%; 20.9 and 11.4% and 44.1 and 27.2%, respectively. The 3-year survival rates and the 3-year disease-free survival rates of IOR-OS/N-5 and our optimized treatments were 62.4 and 78.4%; and 53.6 and 67.8%, respectively. Overall survival and disease-free survival rates were significantly different between these two treatments (P = 0.032 and 0.024, respectively). Liver function with degree III and IV damage accounted for 35.2 and 16.6% of the total adverse reactions in the IOR-OS/N-5 and our optimized treatment groups, respectively. Degree III-IV neutropenia accounted for 22.6 and 40.0%, respectively, in the IOR-OS/N-5 and optimized treatments.

CONCLUSION

The optimization of MTX, DDP, DOX and IFO based on Chinese patients' physiology increased the tolerance and efficacy for the treatment of osteosarcoma.