BACKGROUND: The outcome of patients with metastatic osteosarcoma treated in two consecutive trials from 1986 to 1997 was analyzed to evaluate the efficacy of carboplatin-based multiagent chemotherapy and to identify prognostic factors. The initial study (OS-86) used ifosfamide, cisplatin, doxorubicin, and high-dose methotrexate, and the subsequent study (OS-91) used the same agents at similar doses, but carboplatin was substituted for cisplatin. METHODS: Twelve patients (median age, 15.1 yrs) were treated in OS-86 for osteosarcoma metastatic to the lung only (11 patients) or bone only (1 patient), and 17 patients (median age, 15.1 yrs) were treated in OS-91 for osteosarcoma metastatic to the lung only (12 patients), bone only (2 patients), lung and bone (2 patients), or other site (1 patient). RESULTS: Patients with metastatic disease enrolled in OS-86 and those with metastatic disease enrolled in OS-91 did not differ in terms of demographic features, histologic subtype, site of primary tumor, or site of metastases. There was a difference in survival according to treatment protocol (P = 0.054). All survivors (four of whom were enrolled in OS-86 and one of whom was enrolled in OS-91) had lung metastases only. Five-year survival estimates for patients with lung metastases only were 45.5 +/- 13.7% (OS-86) and 8.3 +/- 5.6% (OS-91) (P = 0.084). Unilateral lung metastases (P = 0.006), no more than three lung nodules (P = 0.014), and surgical remission (P = 0.001) were associated with improved survival probability. CONCLUSIONS: The poor outcome of patients with metastatic osteosarcoma treated in OS-91 justifies the use of cisplatin with its associated toxicity in patients with high-risk disease.
BACKGROUND: The outcome of patients with metastatic osteosarcoma treated in two consecutive trials from 1986 to 1997 was analyzed to evaluate the efficacy of carboplatin-based multiagent chemotherapy and to identify prognostic factors. The initial study (OS-86) used ifosfamide, cisplatin, doxorubicin, and high-dose methotrexate, and the subsequent study (OS-91) used the same agents at similar doses, but carboplatin was substituted for cisplatin. METHODS: Twelve patients (median age, 15.1 yrs) were treated in OS-86 for osteosarcoma metastatic to the lung only (11 patients) or bone only (1 patient), and 17 patients (median age, 15.1 yrs) were treated in OS-91 for osteosarcoma metastatic to the lung only (12 patients), bone only (2 patients), lung and bone (2 patients), or other site (1 patient). RESULTS:Patients with metastatic disease enrolled in OS-86 and those with metastatic disease enrolled in OS-91 did not differ in terms of demographic features, histologic subtype, site of primary tumor, or site of metastases. There was a difference in survival according to treatment protocol (P = 0.054). All survivors (four of whom were enrolled in OS-86 and one of whom was enrolled in OS-91) had lung metastases only. Five-year survival estimates for patients with lung metastases only were 45.5 +/- 13.7% (OS-86) and 8.3 +/- 5.6% (OS-91) (P = 0.084). Unilateral lung metastases (P = 0.006), no more than three lung nodules (P = 0.014), and surgical remission (P = 0.001) were associated with improved survival probability. CONCLUSIONS: The poor outcome of patients with metastatic osteosarcoma treated in OS-91 justifies the use of cisplatin with its associated toxicity in patients with high-risk disease.
Authors: Fariba Navid; Victor M Santana; Michael Neel; M Beth McCarville; Barry L Shulkin; Jianrong Wu; Catherine A Billups; Shenghua Mao; Vinay M Daryani; Clinton F Stewart; Michelle Kunkel; Wendene Smith; Deborah Ward; Alberto S Pappo; Armita Bahrami; David M Loeb; Jennifer Reikes Willert; Bhaskar N Rao; Najat C Daw Journal: Int J Cancer Date: 2017-07-03 Impact factor: 7.396
Authors: Darshana D Rasalkar; Winnie C W Chu; Vincent Lee; Bhawan K Paunipagar; Frankie W T Cheng; Chi Kong Li Journal: Pediatr Radiol Date: 2010-09-03
Authors: Najat C Daw; Michael D Neel; Bhaskar N Rao; Catherine A Billups; Jianrong Wu; Jesse J Jenkins; Juan Quintana; Lori Luchtman-Jones; Milena Villarroel; Victor M Santana Journal: Cancer Date: 2011-01-10 Impact factor: 6.860
Authors: Amos H P Loh; Fariba Navid; Chong Wang; Armita Bahrami; Jianrong Wu; Michael D Neel; Bhaskar N Rao Journal: Ann Surg Oncol Date: 2014-02-21 Impact factor: 5.344
Authors: Alexander J Chou; Eugenie S Kleinerman; Mark D Krailo; Zhengjia Chen; Donna L Betcher; John H Healey; Ernest U Conrad; Michael L Nieder; Michael A Weiner; Robert J Wells; Richard B Womer; Paul A Meyers Journal: Cancer Date: 2009-11-15 Impact factor: 6.860