Adjuvant chemotherapy for non-metastatic osteosarcoma of the extremities in two New Zealand cancer centres
| Autor: | J. Thomson, M. B. Jameson, D. H. Gray, S. G. Allan, V. J. Harvey, B. D. Evans, G. Humm, G. V. Forgeson, Paul Thompson |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty Vincristine Adolescent medicine.medical_treatment Bone Neoplasms Amputation Surgical Folinic acid Clinical Protocols Oncology Service Hospital Antineoplastic Combined Chemotherapy Protocols Internal Medicine medicine Humans Retrospective Studies Chemotherapy Osteosarcoma Tibia business.industry Femoral Neoplasms Cancer Humerus medicine.disease Surgery Clinical trial Survival Rate Regimen Treatment Outcome Amputation Chemotherapy Adjuvant Fibula Female Metastasectomy business medicine.drug New Zealand |
| Zdroj: | Australian and New Zealand journal of medicine. 25(3) |
| ISSN: | 0004-8291 |
| Popis: | 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/m 2 and vincristine 1.5 mg/m 2 (maximum 2 mg) on days 1 and 8 followed by folinic acid then doxorubicin 50 mg/m 2 and cisplatin 100 mg/m 2 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. (Aust NZ J Med 1995 ; 25 : 224-229.) |
| Databáze: | OpenAIRE |
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