Clinical analysis of Chinese limb osteosarcoma patients treated by two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide.

AIMS: The objective of this study was to investigate the efficacy and toxic side effects of two combinations of methotrexate, cisplatin, doxorubicin and ifosfamide on treating Chinese osteosarcoma patients.

METHODS: A retrospective analysis was conducted of 185 osteosarcoma patients treated with the four drugs mentioned above. A total of 93 patients received the Italian therapeutic treatment (IOR-OS/N-5: Instituto Ortopedic Rizzoli-Section of Osteosacorma/Neoadjuvant chemotherapy-5) and the remaining 92 patients received the therapeutic treatment optimized by our department. We compared the efficacy and toxic side effects of these two therapies.

RESULTS: The limb salvage rates, 3-year recurrence rates and 3-year metastasis rates of IOR-OS/N-5 and our optimized treatment were 52.7 and 58.7%; 20.9 and 11.4% and 44.1 and 27.2%, respectively. The 3-year survival rates and the 3-year disease-free survival rates of IOR-OS/N-5 and our optimized treatments were 62.4 and 78.4%; and 53.6 and 67.8%, respectively. Overall survival and disease-free survival rates were significantly different between these two treatments (P = 0.032 and 0.024, respectively). Liver function with degree III and IV damage accounted for 35.2 and 16.6% of the total adverse reactions in the IOR-OS/N-5 and our optimized treatment groups, respectively. Degree III-IV neutropenia accounted for 22.6 and 40.0%, respectively, in the IOR-OS/N-5 and optimized treatments.

CONCLUSION: The optimization of MTX, DDP, DOX and IFO based on Chinese patients' physiology increased the tolerance and efficacy for the treatment of osteosarcoma.