Zheng Shuier, Zhou Shuhui, Qiao Guanglei, Yang Qingcheng, Zhang Zhichang, Lin Feng, Min Daliu, Tang Lina, Li Hongtao, Sun Yuanjue, Zhao Hui, Shen Zan, Yao Yang
Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital 200233 Shanghai, People's Republic of China.
Am J Cancer Res. 2014 Dec 15;5(1):411-22. eCollection 2015.
Pirarubicin (THP) is a newer generation anthracycline anticancer drug with antineoplastic efficacy against numerous tumors. Few studies have reported its application and efficiency in anti-osteosarcoma chemotherapeutic strategies. Ninety-six non-metastatic extremity osteosarcoma patients treated with THP or doxorubicin (DOX) in combination with high-dose methotrexate (HDMTX), cisplatin (DDP) and ifosfamide (IFO) within the past 9 years at our hospital were evaluated retrospectively to compare efficacy and side effects. Among the patients, 55.2% were male, 36.5% were ≤14 years old and 59.4% presented with a large tumor (≥1/3 of bone) to our department. The 5-year disease-free survival (DFS) rate of the patients treated with the THP-based chemotherapeutic regimen was 70.2%, significantly higher than that of the DOX-based regimen-treated group (53.1%). The THP-based chemotherapeutic regimen decreased the lung metastatic rate significantly compared with the DOX-based regimen (19.1% vs. 36.7%, P=0.045), as well as the relapse rate (31.9% vs. 49.0%, P=0.067). Both regimens were generally well tolerated. However, while the THP-based chemotherapeutic regimen did not alter toxicity in the hematologic system, liver or kidneys compared with the DOX-based regimen, it showed lower rates of alopecia (63.8% vs. 85.7%, P=0.012), nausea and vomiting (51.1% vs. 79.6%, P=0.003), and mucositis (48.9% vs. 75.6%, P=0.003). THP also resulted in lower cardiac toxicity. Our data demonstrate that the THP-based regimen is better than the DOX-based regimen in terms of the 5-year DFS rate, pulmonary metastasis rate, relapse rate and side effects.
吡柔比星（THP）是新一代蒽环类抗癌药物，对多种肿瘤具有抗肿瘤疗效。很少有研究报道其在抗骨肉瘤化疗策略中的应用及疗效。回顾性评估我院过去9年内接受THP或多柔比星（DOX）联合大剂量甲氨蝶呤（HDMTX）、顺铂（DDP）和异环磷酰胺（IFO）治疗的96例非转移性肢体骨肉瘤患者的疗效和副作用。患者中，55.2%为男性，36.5%年龄≤14岁，59.4%来我科时肿瘤较大（≥骨的1/3）。接受以THP为基础的化疗方案治疗的患者5年无病生存率（DFS）为70.2%，显著高于接受以DOX为基础的化疗方案治疗的组（53.1%）。与以DOX为基础的化疗方案相比，以THP为基础的化疗方案显著降低了肺转移率（19.1%对36.7%，P = 0.045）以及复发率（31.9%对49.0%，P = 0.067）。两种方案总体耐受性良好。然而，与以DOX为基础的化疗方案相比，以THP为基础的化疗方案在血液系统、肝脏或肾脏方面并未改变毒性，但脱发率（63.8%对85.7%，P = 0.012）、恶心和呕吐率（51.1%对79.6%，P = 0.003）以及黏膜炎发生率（48.9%对75.6%，P = 0.003）较低。THP还导致较低的心脏毒性。我们的数据表明，在5年DFS率、肺转移率、复发率和副作用方面，以THP为基础的化疗方案优于以DOX为基础的化疗方案。
