Zhang Ya, Yang Jingqing, Zhao Na, Wang Cao, Kamar Santosh, Zhou Yonghong, He Zewei, Yang Jifei, Sun Bin, Shi Xiaoqian, Han Lei, Yang Zuozhang
Department of Orthopedics, The Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, Yunnan 650118, P.R. China.
Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650000, P.R. China.
Oncol Lett. 2018 Nov;16(5):6228-6237. doi: 10.3892/ol.2018.9434. Epub 2018 Sep 12.
Osteosarcoma (OS) is the most common type of primary bone tumor in children and adolescents and has been associated with a high degree of malignancy, early metastasis, rapid progression and poor prognosis. However, the use of adjuvant chemotherapy improves the prognosis of patients with OS. OS chemotherapy is based primarily on the use of adriamycin, cisplatin (DDP), methotrexate (MTX), ifosfamide (IFO), epirubicin (EPI) and other drugs. Previous studies have revealed that the survival rate for patients with OS appears to have plateaued: 5-year survival rates remain close to 60%, even with the use of combined chemotherapy. The most limiting factors include complications and fatal toxicity associated with chemotherapy agents, particularly high-dose MTX (HD-MTX), for which high toxicity and great individual variation in responses have been observed. Docetaxel (TXT) is a representative member of the relatively recently developed taxane class of drugs, which function to inhibit OS cell proliferation and induce apoptosis. Recently, more clinical studies have reported that TXT combined with gemcitabine (GEM) is effective in the treatment of OS (relapse/refractory and progressive), providing evidence in support of potential novel treatment strategies for this patient population. However, there is still no global consensus on this type of chemotherapy approach. The present review summarizes current studies surrounding progress in the chemotherapeutic treatment of OS and discusses the advantages and potential feasibility of TXT+GEM in the treatment of OS.
骨肉瘤（OS）是儿童和青少年中最常见的原发性骨肿瘤类型，具有高度恶性、早期转移、进展迅速和预后不良的特点。然而，辅助化疗的使用改善了骨肉瘤患者的预后。骨肉瘤化疗主要基于使用阿霉素、顺铂（DDP）、甲氨蝶呤（MTX）、异环磷酰胺（IFO）、表柔比星（EPI）等药物。先前的研究表明，骨肉瘤患者的生存率似乎已趋于平稳：即使使用联合化疗，5年生存率仍接近60%。最限制因素包括与化疗药物相关的并发症和致命毒性，特别是高剂量甲氨蝶呤（HD-MTX），已观察到其具有高毒性和个体反应差异很大。多西他赛（TXT）是相对较新开发的紫杉烷类药物的代表性成员，其作用是抑制骨肉瘤细胞增殖并诱导凋亡。最近，更多的临床研究报告称，TXT联合吉西他滨（GEM）在治疗骨肉瘤（复发/难治性和进展性）方面有效，为该患者群体的潜在新治疗策略提供了支持证据。然而，对于这种化疗方法仍未达成全球共识。本综述总结了目前围绕骨肉瘤化疗治疗进展的研究，并讨论了TXT+GEM治疗骨肉瘤的优势和潜在可行性。
