ABSTRACT
Objective To investigate the efficacy and side effects of new combination of high-dose methotrexate (MTX),cisplatin (DDP),pirarubicin (THP),and ifosfamide (IFO) in the treatment of extremity osteosarcoma patients.Methods A retrospective analysis was conducted for 125 osteosarcoma patients treated with the optimized neo-adjuvant chemotherapy combined with the four drugs mentioned above (MTX 200 mg/kg iv 6 h d1,CF 9 mg at one time,12 times; DDP 100 mg/m2,THP 30 mg iv,d8-10;IFO 3.0 g/m2 iv d16-18,mesna after IFO for 0,3,6,9 h).The efficacy and side effects of the therapeutic scheme were evaluated.Results The effective salvage rates of Ⅱ a and Ⅱb schemes were 36.4％ (8/22) and 79.6％ (82/103) with a statistical significance (P ＜ 0.05).The 2-year survival rate of schemes was 62.4％,and the survival time was(17.7 ± 8.3)months.The main side effects were myelo-suppression,nausea,and vomiting,etc.The incidence rate of myelo-suppression,nausea,and vomiting with grade Ⅲ-Ⅳ accounted for 71.2％,37.6％,and 13.6％,respectively.Conclusions The optimized neo-adjuvant therapy strategy based on high-dose MTX,DDP,THP,and IFO is effective in the treatment of osteosarcoma.