BACKGROUND: In an effort to intensify osteosarcoma therapy, systemic ifosfamide was added pre- and postoperatively to an already aggressive three-drug regimen. In a subgroup of patients, loco-regional treatment intensification was attempted by using the intraarterial route to give cisplatin. PATIENTS AND METHODS: Patients < or = 40 years at diagnosis of a localised, de novo high-grade central extremity osteosarcoma were eligible for inclusion into study COSS-86 if registered within three weeks from biopsy. Doxorubicin, high-dose methotrexate, and cisplatin were given to all patients. Patients who fulfilled one or more of three defined high-risk criteria received early systemic treatment intensification by adding ifosfamide as the fourth agent. Preoperatively, these high-risk patients received cisplatin either intraarterially or intravenously. RESULTS: 171 eligible patients were entered, of which 128 were stratified into the high-risk group. When all 171 were analysed by intention-to-treat, actuarial overall and event-free survival rates at ten years were 72% and 66%, respectively. No benefit of intraarterial cisplatin application was detected. Cumulative treatment toxicity was considerable. CONCLUSIONS: In a multicenter setting, intensive treatment of osteosarcoma according to protocol COSS-86 led to long-term disease-free survival for two thirds of patients. We saw no benefit of using the intraarterial route to administer cisplatin.
BACKGROUND: In an effort to intensify osteosarcoma therapy, systemic ifosfamide was added pre- and postoperatively to an already aggressive three-drug regimen. In a subgroup of patients, loco-regional treatment intensification was attempted by using the intraarterial route to give cisplatin. PATIENTS AND METHODS: Patients < or = 40 years at diagnosis of a localised, de novo high-grade central extremity osteosarcoma were eligible for inclusion into study COSS-86 if registered within three weeks from biopsy. Doxorubicin, high-dose methotrexate, and cisplatin were given to all patients. Patients who fulfilled one or more of three defined high-risk criteria received early systemic treatment intensification by adding ifosfamide as the fourth agent. Preoperatively, these high-risk patients received cisplatin either intraarterially or intravenously. RESULTS: 171 eligible patients were entered, of which 128 were stratified into the high-risk group. When all 171 were analysed by intention-to-treat, actuarial overall and event-free survival rates at ten years were 72% and 66%, respectively. No benefit of intraarterial cisplatin application was detected. Cumulative treatment toxicity was considerable. CONCLUSIONS: In a multicenter setting, intensive treatment of osteosarcoma according to protocol COSS-86 led to long-term disease-free survival for two thirds of patients. We saw no benefit of using the intraarterial route to administer cisplatin.
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: Dae-Geun Jeon; Won Seok Song; Wan Hyeong Cho; Chang-Bae Kong; Sang Hyun Cho Journal: Clin Orthop Relat Res Date: 2014-02-27 Impact factor: 4.176
Authors: Kentaro Igarashi; Kei Kawaguchi; Tasuku Kiyuna; Kentaro Miyake; Masuyo Miyake; Shukuan Li; Qinghong Han; Yuying Tan; Ming Zhao; Yunfeng Li; Scott D Nelson; Sarah M Dry; Arun S Singh; Irmina A Elliott; Tara A Russell; Mark A Eckardt; Norio Yamamoto; Katsuhiro Hayashi; Hiroaki Kimura; Shinji Miwa; Hiroyuki Tsuchiya; Fritz C Eilber; Robert M Hoffman Journal: Cell Cycle Date: 2018-04-10 Impact factor: 4.534