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Clin Transl Oncol ; 11(6): 387-92, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19531454

ABSTRACT

INTRODUCTION: The long-term results of the Spanish Study Protocol SEOP-SO-95 for treatment of localised osteosarcoma of the extremities in children were evaluated. PATIENTS AND METHODS: One hundred consecutive patients under 18 years of age from 22 institutions were enrolled from January 1995 to December 2000. Immunohistochemical expression of p53, HER/erbB-2 and P-glycoprotein were retrospectively studied in 27 patients. Treatment consisted of: preoperative chemotherapy with doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue and ifosfamide for 14 weeks; surgery of primary tumour in week 16; postoperative chemotherapy with the above-mentioned drugs for 25 weeks. RESULTS: With a median follow-up of 124 months (range 84-158 months), 69 patients (69%) were continuously event-free survivors; the 10-year probability of event-free survival (EFS) was 62%. Conservative surgery was performed in 85% of patients. Twenty-six patients had local recurrence or distant relapse. The median time to recurrence/ relapse was 27 months (range 17-93 months). The local recurrence rate was 7% (7 of the 100 patients); 4 had wide surgical margins, 2 marginal and 1 intralesional. Four patients died as a result of chemotherapy-related toxicity and 1 developed a second neoplasia (acute myeloid leukaemia). p53 expression and HER2/erbB-2 expression showed no effect on survival or EFS. CONCLUSIONS: This therapeutic protocol achieved good oncologic and orthopaedic results. We observed a significant treatment-related toxicity.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/drug therapy , Osteosarcoma/drug therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bone Neoplasms/genetics , Bone Neoplasms/mortality , Bone Neoplasms/surgery , Chemotherapy, Adjuvant , Child , Child, Preschool , Combined Modality Therapy , Disease-Free Survival , Extremities , Female , Follow-Up Studies , Genes, MDR , Genes, erbB-2 , Genes, p53 , Humans , Kaplan-Meier Estimate , Male , Neoadjuvant Therapy , Neoplasm Recurrence, Local/epidemiology , Neoplasms, Second Primary/epidemiology , Osteosarcoma/genetics , Osteosarcoma/mortality , Osteosarcoma/surgery , Postoperative Complications/chemically induced , Postoperative Complications/mortality , Spain/epidemiology
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