Abstract | AIM: Our experience of pre-operative intraarterial (i.a.) vs intravenous (i.v.) infusion of cisplatinum ( CDP) in a multiagent neo- adjuvant chemotherapy for osteosarcoma of the extremity is reported. METHODS: Two successive randomized studies were performed. In the first, pre-operatively, CDP i.a. vs CDP i.v. was applied in combination with high-dose methotrexate (HDMTX) and adriamycin (ADM) within a three- drug regimen. In the second, a combination of HDMTX, ADM and IFO, within a four- drug regimen was tested. RESULTS: The rate of responses to chemotherapy (tumour necrosis > or = 90%) was significantly higher (P<0.04) for the 142 patients treated with the four- drug regimen than in the 79 patients treated with a three- drug regimen (76%vs 62%). According to the route of CDP infusion, in the three- drug regimen the rate of responses was significantly higher (P=0.004) in patients treated with i.a. CDP (77%) than in patients treated i.v. (46%); with the four- drug regimen the rate of response was not significantly different in patients treated i.a. (81%) and in patients treated i.v. (71%). No significant differences in the rates of limb salvages, local recurrence and event-free survival (EFS) were seen between the i.a. and the i.v. groups. CONCLUSION: In the treatment of osteosarcoma of the extremity, the i.a. infusion of CDP does not offer any significant advantage when this drug is used within an aggressive, multiagent, pre-operative four- drug regimen.
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Authors | G Bacci, S Ferrari, A Tienghi, F Bertoni, M Mercuri, A Longhi, G Fiorentini, C Forni, P Bacchini, S Rimondini, U De Giorgi, P Picci |
Journal | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
(Eur J Surg Oncol)
Vol. 27
Issue 1
Pg. 98-104
(Feb 2001)
ISSN: 0748-7983 [Print] England |
PMID | 11237499
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Copyright | Copyright Harcourt Publishers Limited. |
Chemical References |
- Doxorubicin
- Cisplatin
- Ifosfamide
- Methotrexate
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Topics |
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects)
- Bone Neoplasms
(drug therapy, mortality, surgery)
- Chemotherapy, Adjuvant
- Cisplatin
(administration & dosage, adverse effects)
- Combined Modality Therapy
- Disease-Free Survival
- Doxorubicin
(administration & dosage)
- Extremities
- Female
- Humans
- Ifosfamide
(administration & dosage)
- Infusions, Intra-Arterial
- Infusions, Intravenous
- Male
- Methotrexate
(administration & dosage)
- Neoplasm Recurrence, Local
- Osteosarcoma
(drug therapy, mortality, surgery)
- Survival Rate
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