Department of Pediatrics.
Orthopedic Surgery.
Jpn J Clin Oncol. 2020 Aug 4;50(8):948-952. doi: 10.1093/jjco/hyaa070.
The prognosis of patients with relapsed osteosarcoma is extremely poor and the optimal treatment remains to be identified. Here, we retrospectively analysed the clinical outcomes of nine patients with relapsed osteosarcoma treated with temozolomide/etoposide. Of the two patients who received temozolomide/etoposide as palliative therapy for unresectable tumours, one remained alive with stable disease for >4 years. The remaining seven patients received temozolomide/etoposide as adjuvant therapy following resection of relapsed metastatic disease; of these, one was free from disease for 41 months. Potentially beneficial effects were observed in two of three O6-methylguanine-DNA methyltransferase protein-negative patients, whereas all five O6-methylguanine-DNA methyltransferase-positive patients experienced subsequent relapse. None of the patients experienced severe adverse effects requiring hospitalization. Temozolomide/etoposide is a feasible candidate as salvage therapy for relapsed osteosarcoma. Further studies are needed to verify the utility of O6-methylguanine-DNA methyltransferase protein expression as a biomarker for predicting the response to this treatment.
复发性骨肉瘤患者的预后极差，最佳治疗方法仍有待确定。在这里，我们回顾性分析了 9 例接受替莫唑胺/依托泊苷治疗的复发性骨肉瘤患者的临床结果。在 2 例接受替莫唑胺/依托泊苷姑息治疗不可切除肿瘤的患者中，1 例患者疾病稳定，存活时间>4 年。其余 7 例患者在切除复发性转移性疾病后接受替莫唑胺/依托泊苷辅助治疗；其中 1 例无疾病 41 个月。在 3 例 O6-甲基鸟嘌呤-DNA 甲基转移酶蛋白阴性患者中，有 2 例观察到潜在的有益效果，而 5 例 O6-甲基鸟嘌呤-DNA 甲基转移酶蛋白阳性患者均出现随后的复发。没有患者出现需要住院治疗的严重不良反应。替莫唑胺/依托泊苷是复发性骨肉瘤挽救治疗的可行候选药物。需要进一步的研究来验证 O6-甲基鸟嘌呤-DNA 甲基转移酶蛋白表达作为预测对这种治疗反应的生物标志物的效用。
