Long-term results of the co-operative German-Austrian-Swiss osteosarcoma study group's protocol COSS-86 of intensive multidrug chemotherapy and surgery for osteosarcoma of the limbs
| Autor: | N. Fuchs, Norbert Graf, Dieter Körholz, D Epler, M. Salzer-Kuntschik, Heribert Jürgens, Rainer Kotz, P. Weinel, G. Delling, P Bieling, Mathias Werner, K. Winkler, Stefan S. Bielack, U. Heise |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Bone Neoplasms Risk Factors Antineoplastic Combined Chemotherapy Protocols medicine Humans Infusions Intra-Arterial Ifosfamide Infusions Intravenous Survival rate Neoadjuvant therapy Chemotherapy Leg Osteosarcoma Intention-to-treat analysis business.industry Hematology medicine.disease Chemotherapy regimen Survival Analysis Neoadjuvant Therapy Surgery Regimen Methotrexate Treatment Outcome Oncology Doxorubicin Child Preschool Arm Female Cisplatin business medicine.drug |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 9(8) |
| ISSN: | 0923-7534 |
| Popis: | Summary 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 < 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. |
| Databáze: | OpenAIRE |
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