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KMID : 0360320010330060520
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Journal of Korean Cancer Research Association
2001 Volume.33 No. 6 p.520 ~ p.526
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Efficacy of Pre- and Postoperative Chemotherapy in Patients with Osteosarcoma of the Extremities
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손주혁/Joo Hyuk Sohn
라선영/정희철/신현준/구영석/정현철/양우익/한수봉/신규호/민진식/김병수/노재경/장우익/Sun Young Rha/Hei Cheul Jeung/Hyun Joon Shin/Young Suck Goo/Hyun Cheol Chung/Woo Ick Yang/Soo Bong Hahn/Kyu Ho Shin/Jin Sik Min/Byung Soo Kim/Jae Kyung Roh/Woo Ick Jang
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Abstract
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PURPOSE:
We evaluated the treatment efficacy including survival and recurrence, and factors associated with recurrence in osteosarcoma patients treated with preoperative chemotherapy, surgery, and adjuvant chemotherapy.
MATERIALS AND METHODS:
Forty nine patients with osteosarcoma were treated with preoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion for 3 cycles, followed by surgery. According to the pathologic response, if tumor was necrotized more than 90%, the same adjuvant chemotherapy was reintroduced for 3 cycles, and if the response was not enough, then the salvage regimen was introduced. Plain chest film and chest CT scan were taken monthly and every 3 months, respectively. When tumor recurred, the metastasectomy was performed whenever possible.
RESULTS:
Forty three patients were evaluable with amedian follow up of 53 months. Five-year disease-free and overallsurvival rate was 47.0% and 66.9%, respectively. The recurrence was observed in 22 patients (51.2%) with median time of 12.5 months. Baseline alkaline phosphatase (ALP) was the only significant factor for recurrence (p=0.03) and the patients with the possibility of metastasectomy recurrence showed higher post-relapse survival compared to other treatment modalities (26 momths vs 5~12 months).
CONCLUSION:
These results indicates that pre- and postoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion showed comparable treatment efficacy and acceptable toxicities.
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KEYWORD
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Osteosarcoma, Neoadjuvant chemotherapy, Recurrence, Metastasectomy,
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