Addition of pamidronate to chemotherapy for the treatment of osteosarcoma
Article first published online: 8 NOV 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 8, pages 1736–1744, 15 April 2011
How to Cite
Meyers, P. A., Healey, J. H., Chou, A. J., Wexler, L. H., Merola, P. R., Morris, C. D., Laquaglia, M. P., Kellick, M. G., Abramson, S. J. and Gorlick, R. (2011), Addition of pamidronate to chemotherapy for the treatment of osteosarcoma. Cancer, 117: 1736–1744. doi: 10.1002/cncr.25744
- Issue published online: 6 APR 2011
- Article first published online: 8 NOV 2010
- Manuscript Accepted: 20 SEP 2010
- Manuscript Revised: 5 AUG 2010
- Manuscript Received: 12 MAY 2010
- limb-sparing surgery;
- endoprosthetic reconstruction
This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma.
The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated.
For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances.
Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction. Cancer 2011. © 2010 American Cancer Society.