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Histologic Response and Toxicity following Interval-Compressed Four-Drug Therapy Given Preoperatively in Children and Young Adults with Osteosarcoma: A Retrospective Study.
Kang, Ji-Man; Ju, Hee Young; Joo, Jungnam; Sung, Jee Young; Park, Seog Yun; Kim, June Hyuk; Kang, Hyun Guy; Kwon, Mimi; Park, Meerim; Park, Hyeon Jin; Park, Byung-Kiu.
Afiliación
  • Kang JM; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea.
  • Ju HY; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea.
  • Joo J; Division of Cancer Epidemiology and Management, National Cancer Center, Goyang, Republic of Korea.
  • Sung JY; Division of Clinical Research, National Cancer Center, Goyang, Republic of Korea.
  • Park SY; Department of Pathology, National Cancer Center, Goyang, Republic of Korea.
  • Kim JH; Orthopaedic Oncology Clinic, National Cancer Center, Goyang, Republic of Korea.
  • Kang HG; Orthopaedic Oncology Clinic, National Cancer Center, Goyang, Republic of Korea.
  • Kwon M; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea.
  • Park M; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea.
  • Park HJ; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea.
  • Park BK; Center for Pediatric Oncology, National Cancer Center, Goyang, Republic of Korea, bkpark@ncc.re.kr.
Oncology ; 98(2): 81-90, 2020.
Article en En | MEDLINE | ID: mdl-31509843
ABSTRACT

OBJECTIVES:

The histologic response to chemotherapy is an important prognostic factor in osteosarcoma. Thus, we attempted to develop an effective neoadjuvant regimen to achieve an improvement in histologic response.

METHODS:

Twenty-nine patients with a high-grade osteosarcoma received 2 courses of neoadjuvant chemotherapy non-randomly with either the MAP regimen (methotrexate 12 g/m2, cisplatin 120 mg/m2, and doxorubicin 75 mg/m2) or MAPI regimen (MAP plus ifosfamide 9 g/m2). We applied interval compression to MAPI by shortening the preoperative period to be aligned with that of MAP. Adjuvant chemotherapy was tailored according to the necrosis rate of resected tumor specimens. Necrosis rate, toxicity, and survival outcome were compared retrospectively between the 2 groups.

RESULTS:

The median interval between the beginning of neoadjuvant chemotherapy and surgery was 97.0 days in the MAPI group (17 patients) and 90.5 days in the MAP group (12 patients; p = 0.19). The good histologic response (>90% of necrosis) was observed in 71% of MAPI and in 42% of MAP (p = 0.12). Major toxicities of grade 3 or worse were not different between the 2 groups. The probability of 5-year progression-free survival and overall survival of the MAPI group were 74 and 83%, and those in the MAP group were 50 and 75%, showing no difference.

CONCLUSIONS:

Interval-compressed MAPI therapy given in a similar duration of the preoperative phase to that of conventional MAP therapy showed a marginal trend toward a better histologic response without a significant increase in major toxicities. Regarding the proportion of good histologic response, 71% is one of the highest values ever reported in the literature. The results warrant further testing in a prospective way in a larger cohort.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Óseas / Cuidados Preoperatorios / Protocolos de Quimioterapia Combinada Antineoplásica / Osteosarcoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Oncology Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Óseas / Cuidados Preoperatorios / Protocolos de Quimioterapia Combinada Antineoplásica / Osteosarcoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Oncology Año: 2020 Tipo del documento: Article