Adjuvant chemotherapy for non-metastatic osteosarcoma of the extremities in two New Zealand cancer centres.

Abstract

BACKGROUND:

Adjuvant chemotherapy significantly improves survival of patients with non-metastatic osteosarcoma but most of the data come from trials conducted in major international cancer centres.

AIM:

To review the efficacy and toxicity of an adjuvant chemotherapy regimen used in two regional cancer centres in New Zealand.

METHODS:

Retrospective review of patients treated for non-metastatic high-grade osteosarcoma of the extremities. The regimen (POMA) consists of high-dose-methotrexate 8 g/m2 and vincristine 1.5 mg/m2 (maximum 2 mg) on days 1 and 8 followed by folinic acid then doxorubicin 50 mg/m2 and cisplatin 100 mg/m2 on day 15. This cycle was repeated every 35 days. Following amputation patients received six cycles while in selected patients two cycles were planned prior to limb salvage surgery followed by a further four cycles. Actuarial survival was calculated using the Kaplan-Meier method.

RESULTS:

Twenty patients were treated with POMA between 1986 and 1993. Amputation was performed in 16 patients and limb-salvage surgery in four. Sixteen patients (80%) remain alive with no evidence of disease at a median follow-up of 40 months. Thirteen patients (65%) have been continuously disease-free. Actuarial survival at five years is 70%. Seven patients relapsed, six in lungs, of whom four underwent pulmonary metastasectomy; three of these remain free of disease 31, 35 and 40 months later. There was no local relapse. The toxicity of POMA is significant but tolerable.

CONCLUSION:

The results obtained at two regional cancer centres in New Zealand using POMA compare favourably to those achieved in clinical trials performed at major international cancer centres.

• Authors: M B Jameson, B D Evans, D H Gray, G V Forgeson, S G Allan, G Humm, J Thomson, P I Thompson, V J Harvey
• Journal: Australian and New Zealand journal of medicine (Aust N Z J Med) Vol. 25 Issue 3 Pg. 224-9 (Jun 1995) ISSN: 0004-8291 [Print] Australia
• PMID: 7487690 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Amputation, Surgical
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Neoplasms (drug therapy, mortality, surgery)
• Chemotherapy, Adjuvant
• Clinical Protocols
• Female
• Femoral Neoplasms (drug therapy, surgery)
• Fibula
• Humans
• Humerus
• Male
• New Zealand
• Oncology Service, Hospital
• Osteosarcoma (drug therapy, mortality, surgery)
• Retrospective Studies
• Survival Rate
• Tibia
• Treatment Outcome