Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam.
Department of Medical Oncology I, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam.
Cancer Control. 2024 Jan-Dec;31:10732748241274188. doi: 10.1177/10732748241274188.
The standard treatment for localized osteosarcoma is neoadjuvant chemotherapy before surgery, followed by adjuvant chemotherapy. Our aim was to report the rate of histopathological response to neoadjuvant chemotherapy for the treatment of extremity osteosarcoma in Vietnam.
We performed a retrospective study of stage II conventional osteosarcoma patients under 40 years-old who received MAP regimen as neoadjuvant chemotherapy at the Vietnam National Cancer Hospital between June 2019 and June 2022. Histopathological response was evaluated using the Huvos grading system, in which a good histopathological response was defined as a necrotic rate of 90% or more.
Thirty-five eligible patients were included in the study. Male patients accounted for 65.7%, with a median age of 16 years (range, 8-38 years). Of the 35 cases, 31 were reported as stage IIB (88.6%). The femur and tibia were the most common sites in our study, accounting for 51.4% and 34.3%, respectively. The most common pathologic subtype was osteoblastic osteosarcoma (68.6%), followed by chondroblastic subtype (20%). After two cycles of MAP-regimen neoadjuvant chemotherapy, 28 of 35 patients (80%) underwent limb-sparing surgery. A good histopathological response was observed in 18 of 35 patients (51.4%). There were significant correlations between the duration of symptoms ( = 0.016), LDH ( = 0.001) serum levels at initial presentation, and ALP ( = 0.043) serum levels at initial presentation with histopathological response.
This retrospective study suggests a possible association between symptom duration, pre-treatment LDH levels, and pre-treatment ALP levels with histopathological response rates. Additional clinical investigations with long-term follow-up are needed to investigate survival outcomes in the Asian population.
局部骨肉瘤的标准治疗方法是手术前进行新辅助化疗，然后进行辅助化疗。我们的目的是报告越南治疗肢体骨肉瘤的新辅助化疗的组织病理学反应率。
我们对 2019 年 6 月至 2022 年 6 月期间在越南国家癌症医院接受 MAP 方案作为新辅助化疗的 40 岁以下 II 期常规骨肉瘤患者进行了回顾性研究。使用 Huvos 分级系统评估组织病理学反应，其中良好的组织病理学反应定义为坏死率 90%或更高。
研究纳入 35 例符合条件的患者。男性占 65.7%，中位年龄为 16 岁（范围 8-38 岁）。35 例中，有 31 例报告为 IIB 期（88.6%）。股骨和胫骨是我们研究中最常见的部位，分别占 51.4%和 34.3%。最常见的病理亚型是成骨型骨肉瘤（68.6%），其次是软骨母细胞型（20%）。在 MAP 方案新辅助化疗两个周期后，35 例患者中有 28 例（80%）接受了保肢手术。35 例患者中有 18 例（51.4%）观察到良好的组织病理学反应。症状持续时间（ = 0.016）、初始时血清 LDH（ = 0.001）水平和初始时血清 ALP（ = 0.043）水平与组织病理学反应之间存在显著相关性。
这项回顾性研究表明，症状持续时间、治疗前 LDH 水平和治疗前 ALP 水平与组织病理学反应率之间可能存在关联。需要进行更多具有长期随访的临床研究，以调查亚洲人群的生存结果。
