TY - JOUR
T1 - Pediatric osteosarcoma
T2 - Therapeutic strategies, results, and prognostic factors derived from a 10-year experience
AU - Hudson, Melissa
AU - Jaffe, Mark Robert
AU - Jaffe, Norman
AU - Ayala, Alberto
AU - Raymond, A. Kevin
AU - Carrasco, Humberto
AU - Wallace, Sidney
AU - Murray, John
AU - Robertson, Resa
PY - 1990/12
Y1 - 1990/12
N2 - Ninety-eight pediatric patients were treated with three separate protocols (Treatment and Investigation of Osteosarcoma [TIOS] I, II, and III) and 47 developed recurrent disease (metastases and/or local recurrence). Actuarial overall disease-free survival (hereafter designated survival) was 43%. Over 90% of the patients were treated initially with preoperative intraarterial cisplatin (CDP). Postoperative chemotherapeutic regimens comprised high-dose methotrexate with leucovorin rescue (MTX-CF), Adriamycin ([ADR] doxorubicin; Adria Laboratories, Columbus, OH), and cyclophosphamide. Primary definitive treatment comprised amputation or limb salvage (TIOS I and TIOS III). Patients treated with preoperative CDP and sur-gery (TIOS I and III) had a 62% survival. Patients in TIOS II refused surgical extirpation; they were treated exclusively with chemotherapy and had a 23% survival. Survival in patients treated with amputation was 55% and limb salvage 58%. Prognostic factors considered significant in relation to development of pulmonary metastases comprised tumor burden (P = .04) and the percentage of tumor necrosis induced by preoperative chemotherapy (P = .01). Histopathologic subtype was marginally significant: chondroblastic was more favorable as opposed to osteoblastic (P = .05). These findings are compared with results and prognostic factors published in the literature.
AB - Ninety-eight pediatric patients were treated with three separate protocols (Treatment and Investigation of Osteosarcoma [TIOS] I, II, and III) and 47 developed recurrent disease (metastases and/or local recurrence). Actuarial overall disease-free survival (hereafter designated survival) was 43%. Over 90% of the patients were treated initially with preoperative intraarterial cisplatin (CDP). Postoperative chemotherapeutic regimens comprised high-dose methotrexate with leucovorin rescue (MTX-CF), Adriamycin ([ADR] doxorubicin; Adria Laboratories, Columbus, OH), and cyclophosphamide. Primary definitive treatment comprised amputation or limb salvage (TIOS I and TIOS III). Patients treated with preoperative CDP and sur-gery (TIOS I and III) had a 62% survival. Patients in TIOS II refused surgical extirpation; they were treated exclusively with chemotherapy and had a 23% survival. Survival in patients treated with amputation was 55% and limb salvage 58%. Prognostic factors considered significant in relation to development of pulmonary metastases comprised tumor burden (P = .04) and the percentage of tumor necrosis induced by preoperative chemotherapy (P = .01). Histopathologic subtype was marginally significant: chondroblastic was more favorable as opposed to osteoblastic (P = .05). These findings are compared with results and prognostic factors published in the literature.
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U2 - 10.1200/JCO.1990.8.12.1988
DO - 10.1200/JCO.1990.8.12.1988
M3 - Article
C2 - 2230890
AN - SCOPUS:0025695318
SN - 0732-183X
VL - 8
SP - 1988
EP - 1997
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 12
ER -