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Results of two consecutive therapeutic trials at St. Jude Children's Research Hospital
Version of Record online: 13 DEC 2005
Copyright © 2005 American Cancer Society
Volume 106, Issue 2, pages 403–412, 15 January 2006
How to Cite
Daw, N. C., Billups, C. A., Rodriguez-Galindo, C., McCarville, M. B., Rao, B. N., Cain, A. M., Jenkins, J. J., Neel, M. D. and Meyer, W. H. (2006), Metastatic osteosarcoma. Cancer, 106: 403–412. doi: 10.1002/cncr.21626
Presented in part at the 38th Annual Meeting of the American Society of Clinical Oncology, May 18– 21, 2002.
- Issue online: 5 JAN 2006
- Version of Record online: 13 DEC 2005
- Manuscript Accepted: 21 JUL 2005
- Manuscript Revised: 17 JUN 2005
- Manuscript Received: 15 APR 2005
- Cancer Center Support (CORE). Grant Number: CA21765
- National Cancer Institute. Grant Number: CA23099
- American Lebanese Syrian Associated Charities (ALSAC)
- metastatic osteosarcoma;
- therapeutic trials;
The outcome of patients with metastatic osteosarcoma treated in two consecutive trials from 1986 to 1997 was analyzed to evaluate the efficacy of carboplatin-based multiagent chemotherapy and to identify prognostic factors. The initial study (OS-86) used ifosfamide, cisplatin, doxorubicin, and high-dose methotrexate, and the subsequent study (OS-91) used the same agents at similar doses, but carboplatin was substituted for cisplatin.
Twelve patients (median age, 15.1 yrs) were treated in OS-86 for osteosarcoma metastatic to the lung only (11 patients) or bone only (1 patient), and 17 patients (median age, 15.1 yrs) were treated in OS-91 for osteosarcoma metastatic to the lung only (12 patients), bone only (2 patients), lung and bone (2 patients), or other site (1 patient).
Patients with metastatic disease enrolled in OS-86 and those with metastatic disease enrolled in OS-91 did not differ in terms of demographic features, histologic subtype, site of primary tumor, or site of metastases. There was a difference in survival according to treatment protocol (P = 0.054). All survivors (four of whom were enrolled in OS-86 and one of whom was enrolled in OS-91) had lung metastases only. Five-year survival estimates for patients with lung metastases only were 45.5 ± 13.7% (OS-86) and 8.3 ± 5.6% (OS-91) (P = 0.084). Unilateral lung metastases (P = 0.006), no more than three lung nodules (P = 0.014), and surgical remission (P = 0.001) were associated with improved survival probability.
The poor outcome of patients with metastatic osteosarcoma treated in OS-91 justifies the use of cisplatin with its associated toxicity in patients with high-risk disease. Cancer 2006. © 2005 American Cancer Society.