Neoadjuvant Chemotherapy for Extremity Osteosarcoma: Preliminary Results of the Rizzoli's 4th Study

Authors

  • Gaetano Bacci From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Stefano Ferrari From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Mario Mercuri From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Alessandra Longhi From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Rodolfo Capanna From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Amelia Tienghi From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Alessandro Comandone From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Cesari Marilena From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Gabriella Bernini From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy
  • Piero Picci From the Department of Chemotherapy (G. Bacci, S. Ferrari, A. Longhi, M. Cesari), 5th Department of Orthopaedic Surgery (M. Mercuri), Laboratory of Oncologic Research (P. Picci), Istituto Ortopedico Rizzoli, Bologna, Department of Orthopaedic Oncology and Reconstructive Surgery, CTO, Firenze, (R. Capanna), Department of Medical Oncology, Ospedale Santa Croce, Ravenna, (A. Tienghi), Pediatric Clinic, Torino University (A. Brach del Prever), Department of Medical Oncology, Ospedale S. Giovanni Vecchio, Torino (A. Comandone), and the Unit of Pediatric Oncohematology, Istituto Mayer Firenze (G. Bernini), Italy

DOI:

https://doi.org/10.1080/028418698423168

Abstract

A neoadjuvant chemotherapy protocol (1/93-1/95) for extremity osteosarcoma preoperatively using high-dose methotrexate (HDMTX) as single agent per cycle and three different combinations of other drugs (CDP/IFO,CDP/ADM,IFO/ADM) is reported. The four drugs were used postoperatively as single agents. Treatment was uniform, but suspended earlier if total necrosis was attained. An improvement was found in the results of the previous study using only IFO postoperatively, with 16/119 patients (97%) avoiding amputation, and 38 (32%) attaining complete necrosis. At a 3-year (2-4 years) mean follow-up, 92 patients (76%) remained continuously disease-free, 2 died of chemotherapy-related toxicity and 25 suffered relapse. Projected 3-year DFS also improved (75% vs. 60%; p=0.04). Despite limb salvage, local recurrences (6.3%) and infections were few, although postoperative chemotherapy was restarted within a week. Therefore, until new effective drugs are found, expertise in using the four known drugs may improve cure rate and help to avoid amputation in almost all patients.

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Published

1998-01-01

How to Cite

Bacci, G. ., Ferrari, S. ., Mercuri, M. ., Longhi, A. ., Capanna, R. ., Tienghi, A. ., … Picci, P. . (1998). Neoadjuvant Chemotherapy for Extremity Osteosarcoma: Preliminary Results of the Rizzoli’s 4th Study. Acta Oncologica, 37(1), 41–48. https://doi.org/10.1080/028418698423168

Issue

Vol. 37 No. 1 (1998): Acta Oncologica

Section

Articles