Journal of Clinical Oncology, Vol 10, 1579-1591, Copyright © 1992 by American Society of Clinical Oncology
A comparison of two short intensive adjuvant chemotherapy regimens in operable osteosarcoma of limbs in children and young adults: the first study of the European Osteosarcoma Intergroup
VH Bramwell, M Burgers, R Sneath, R Souhami, AT van Oosterom, PA Voute, J Rouesse, D Spooner, AW Craft and R Somers
London Regional Cancer Centre, East London, Canada.
PURPOSE: A randomized pilot study was undertaken to assess the acute and
chronic toxicities of two short intensive chemotherapy regimens, and to
evaluate the feasibility of conservative surgery in this setting.
Additional aims were to determine the clinical and radiologic response and
the degree of histologic necrosis after chemotherapy. With extension of the
study, eventual accrual was sufficient to compare disease-free survival
(DFS) and overall survival (OS). PATIENTS AND METHODS: Between July 1983
and December 1986, the European Osteosarcoma Intergroup (EOI) entered 198
eligible patients with classic high-grade extremity osteosarcoma onto a
randomized trial that compared doxorubicin (DOX) 25 mg/m2/d times three,
intravenous (IV) bolus plus cisplatin (CDDP) 100 mg/m2, 24 hour infusion,
every 3 weeks times six; the same combination was preceded 10 days earlier
by high-dose methotrexate (HDMTX) 8 g/m2, 6-hour infusion, every 4.5 weeks
times four. In the majority of patients (179), chemotherapy was commenced
after biopsy; definitive surgery was scheduled at 9 weeks in both groups.
RESULTS: Toxicities for both regimens did not differ substantially from
those that occurred in other trials of adjuvant chemotherapy in
osteosarcoma. Local recurrence (9%) and surgical complications (18%) after
conservative surgery were acceptable. With a median follow-up of 53 months,
DFS at 5 years is superior (P = .02) for DOX/CDDP, 57% versus 41%, although
OS, 64% versus 50%, is not different significantly (P = .10). In a subset
of 66 patients for whom pathologic data on the resected specimen were
available, DFS (P = .003) and OS (P = .008) were better for those who
demonstrated > or = 90% necrosis. CONCLUSION: A brief intensive
chemotherapy regimen of DOX/CDDP has produced excellent long-term results,
which are similar to those that have been achieved in cooperative group
studies of longer, more complex multiagent chemotherapy, and provide the
basis for a direct comparison in the next EOI study.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
B. G. I. Spiegelberg, M. D. Sewell, W. J. S. Aston, G. W. Blunn, R. Pollock, S. R. Cannon, and T. W. R. Briggs
The early results of joint-sparing proximal tibial replacement for primary bone tumours, using extracortical plate fixation
J Bone Joint Surg Br,
October 1, 2009;
91-B(10):
1373 - 1377.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Jaffe and R. Gorlick
High-Dose Methotrexate in Osteosarcoma: Let the Questions Surcease--Time for Final Acceptance
J. Clin. Oncol.,
September 20, 2008;
26(27):
4365 - 4366.
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. J. Lewis, M. A. Nooij, J. Whelan, M. R. Sydes, R. Grimer, P. C. W. Hogendoorn, M. A. Memon, S. Weeden, B. M. Uscinska, M. van Glabbeke, et al.
Improvement in Histologic Response But Not Survival in Osteosarcoma Patients Treated With Intensified Chemotherapy: A Randomized Phase III Trial of the European Osteosarcoma Intergroup
J Natl Cancer Inst,
January 17, 2007;
99(2):
112 - 128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T.-a. Matsui, Y. Sowa, T. Yoshida, H. Murata, M. Horinaka, M. Wakada, R. Nakanishi, T. Sakabe, T. Kubo, and T. Sakai
Sulforaphane enhances TRAIL-induced apoptosis through the induction of DR5 expression in human osteosarcoma cells
Carcinogenesis,
September 1, 2006;
27(9):
1768 - 1777.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Ferrari, S. Smeland, M. Mercuri, F. Bertoni, A. Longhi, P. Ruggieri, T. A. Alvegard, P. Picci, R. Capanna, G. Bernini, et al.
Neoadjuvant Chemotherapy With High-Dose Ifosfamide, High-Dose Methotrexate, Cisplatin, and Doxorubicin for Patients With Localized Osteosarcoma of the Extremity: A Joint Study by the Italian and Scandinavian Sarcoma Groups
J. Clin. Oncol.,
December 1, 2005;
23(34):
8845 - 8852.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Marina, M. Gebhardt, L. Teot, and R. Gorlick
Biology and Therapeutic Advances for Pediatric Osteosarcoma
Oncologist,
July 1, 2004;
9(4):
422 - 441.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Bacci, A. Briccoli, M. Rocca, S. Ferrari, D. Donati, A. Longhi, F. Bertoni, P. Bacchini, S. Giacomini, C. Forni, et al.
Neoadjuvant chemotherapy for osteosarcoma of the extremities with metastases at presentation: recent experience at the Rizzoli Institute in 57 patients treated with cisplatin, doxorubicin, and a high dose of methotrexate and ifosfamide
Ann. Onc.,
July 1, 2003;
14(7):
1126 - 1134.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
The Colorectal Cancer Chemotherapy Study Group of
Results of a Randomized Trial with or without 5-FU-based Preoperative Chemotherapy followed by Postoperative Chemotherapy in Resected Colon and Rectal Carcinoma
Jpn. J. Clin. Oncol.,
June 1, 2003;
33(6):
288 - 296.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Goorin, D. J. Schwartzentruber, M. Devidas, M. C. Gebhardt, A. G. Ayala, M. B. Harris, L. J. Helman, H. E. Grier, and M. P. Link
Presurgical Chemotherapy Compared With Immediate Surgery and Adjuvant Chemotherapy for Nonmetastatic Osteosarcoma: Pediatric Oncology Group Study POG-8651
J. Clin. Oncol.,
April 15, 2003;
21(8):
1574 - 1580.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Ferrari, A. Briccoli, M. Mercuri, F. Bertoni, P. Picci, A. Tienghi, A. B. Del Prever, F. Fagioli, A. Comandone, and G. Bacci
Postrelapse Survival in Osteosarcoma of the Extremities: Prognostic Factors for Long-Term Survival
J. Clin. Oncol.,
February 15, 2003;
21(4):
710 - 715.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Serra, K. Scotlandi, G. Reverter-Branchat, S. Ferrari, M. C. Manara, S. Benini, M. Incaprera, F. Bertoni, M. Mercuri, A. Briccoli, et al.
Value of P-Glycoprotein and Clinicopathologic Factors as the Basis for New Treatment Strategies in High-Grade Osteosarcoma of the Extremities
J. Clin. Oncol.,
February 1, 2003;
21(3):
536 - 542.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Janinis, A. McTiernan, D. Driver, C. Mitchell, A. M. Cassoni, J. Pringle, A. Kilby, and J. S. Whelan
A pilot study of short-course intensive multiagent chemotherapy in metastatic and axial skeletal osteosarcoma
Ann. Onc.,
December 1, 2002;
13(12):
1935 - 1944.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S. Bielack, B. Kempf-Bielack, G. Delling, G. U. Exner, S. Flege, K. Helmke, R. Kotz, M. Salzer-Kuntschik, M. Werner, W. Winkelmann, et al.
Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols
J. Clin. Oncol.,
February 1, 2002;
20(3):
776 - 790.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. J. Veal, C. Dias, L. Price, A. Parry, J. Errington, J. Hale, A. D. J. Pearson, A. V. Boddy, D. R. Newell, and M. J. Tilby
Influence of Cellular Factors and Pharmacokinetics on the Formation of Platinum-DNA Adducts in Leukocytes of Children Receiving Cisplatin Therapy
Clin. Cancer Res.,
August 1, 2001;
7(8):
2205 - 2212.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Bacci, S. Ferrari, F. Bertoni, P. Ruggieri, P. Picci, A. Longhi, R. Casadei, N. Fabbri, C. Forni, M. Versari, et al.
Long-Term Outcome for Patients With Nonmetastatic Osteosarcoma of the Extremity Treated at the Istituto Ortopedico Rizzoli According to the Istituto Ortopedico Rizzoli/Osteosarcoma-2 Protocol: An Updated Report
J. Clin. Oncol.,
December 15, 2000;
18(24):
4016 - 4027.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. J. Lewis, S. Weeden, D. Machin, D. Stark, and A. W. Craft
Received Dose and Dose-Intensity of Chemotherapy and Outcome in Nonmetastatic Extremity Osteosarcoma
J. Clin. Oncol.,
December 15, 2000;
18(24):
4028 - 4037.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. H.C. Bramwell, W. P. Steward, M. Nooij, J. Whelan, A. W. Craft, R. J. Grimer, A. H.M. Taminau, S. R. Cannon, A. J. Malcolm, P. C.W. Hogendoorn, et al.
Neoadjuvant Chemotherapy With Doxorubicin and Cisplatin in Malignant Fibrous Histiocytoma of Bone: A European Osteosarcoma Intergroup Study
J. Clin. Oncol.,
October 1, 1999;
17(10):
3260 - 3269.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A.S. Arndt and W. M. Crist
Common Musculoskeletal Tumors of Childhood and Adolescence
N. Engl. J. Med.,
July 29, 1999;
341(5):
342 - 352.
[Full Text]
[PDF]
|
|
|
|
