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Adjuvant multiple drug chemotherapy for osteosarcoma of the extremity
Author(s) -
Pratt Charles,
Shanks Ellen,
Hustu Omar,
Rivera Gaston,
Smith John,
Kumar A. P. Mahesh
Publication year - 1977
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197701)39:1<51::aid-cncr2820390110>3.0.co;2-t
Subject(s) - medicine , osteosarcoma , chemotherapy , amputation , cyclophosphamide , surgery , nausea , vomiting , methotrexate , oncology , pathology
Abstract Results of treatment for osteosarcoma of the extremity have been poor with metastases usually causing death within 2 years following diagnosis. Because of the great risk of development of metastases, 20 patients have received adjuvant chemotherapy with Adriamycin, cyclophosphamide and high‐dose meth‐otrexate‐leucovorin rescue for up to 12 months following amputation for osteosarcoma. Sixteen of these patients are surviving; 11 are free of evident tumor from 6 to 34 months following amputation. Five patients were found to have pulmonary metastases while receiving chemotherapy and three patients developed metastases following completion of chemotherapy. One patient died following her third treatment with high‐dose methotrexate‐leucorovin rescue. Other toxicity included nausea, vomiting, mucosal ulcerations, infections, hematologic abnormalities, changes in kidney and liver functions tests, and minor coagulation abnormalities. The natural history of osteosarcoma may have been modified by the use of these agents for periods exceeding the median time to predicted detection of pulmonary metastases. Microscopic metastases of some patients were eradicated by this adjuvant chemotherapy. For patients who developed metastases, these metastases were delayed in their time of detection and in their number at the time of detection.