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- Title
Methotrexate–Etoposide–Ifosfamide Compared with Doxorubicin–Cisplatin–Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18–25 Years.
- Authors
Marec-Berard, Perrine; Laurence, Valérie; Occean, Bob-Valéry; Ray-Coquard, Isabelle; Linassier, Claude; Corradini, Nadège; Collard, Olivier; Chaigneau, Loïc; Cupissol, Didier; Kerbrat, Pierre; Saada-Bouzid, Esma; Delcambre, Corinne; Gouin, François; Guillemet, Cécile; Jimenez, Marta; Lervat, Cyril; Gaspar, Nathalie; Le Deley, Marie-Cécile; Brugieres, Laurence; Piperno-Neumann, Sophie
- Abstract
Purpose: The French standard chemotherapy for osteosarcoma combines high-dose methotrexate (HDM) and etoposide–ifosfamide (EI) in children and adolescents, and API-AI (doxorubicin–cisplatin–ifosfamide) in adults. We herein present the results of M-EI and API-AI in 18- to 25-year-old patients. Methods: Patients, 18–25 years old, received either M-EI or API-AI regimens. M-EI comprised seven M and two EI doses preoperatively then M-EI in standard-risk patients (good histological response without metastasis) and five M-AP (methotrexate–doxorubicin–cisplatin) in high-risk patients (poor histological response, metastasis, and/or unresectable primary), postoperatively. API-AI comprised three API and two AI doses preoperatively, then two AI and two PI in standard-risk patients and five EI in high-risk patients, postoperatively. Results: We analyzed 95 patients 18–25 years of age: 55 received M-EI and 40 API-AI. The groups had similar baseline characteristics. Eighty-nine patients (94%) had surgery. Twenty-nine of 55 M-EI patients (60%) and 16/40 API-AI patients (41%) had good histological responses to preoperative chemotherapy. At 5 years, event-free survival was 50% (95% confidence interval [CI]: 39–60) and overall survival was 65% (95% CI: 54–74). Acute toxicity was similar, without treatment-related deaths. Conclusions: Survival outcomes with M-EI and API-AI were not significantly different. Tolerance was acceptable with both regimens. HDM is thus feasible for young adults. However, our study limitations preclude any definitive conclusions.
- Subjects
CANCER chemotherapy; CISPLATIN; COMPARATIVE studies; CONFIDENCE intervals; DOSE-response relationship in biochemistry; DOXORUBICIN; DRUG tolerance; DRUG toxicity; ETOPOSIDE; METASTASIS; METHOTREXATE; OSTEOSARCOMA; POSTOPERATIVE period; RISK assessment; SURVIVAL analysis (Biometry); RANDOMIZED controlled trials; TREATMENT effectiveness; PREOPERATIVE period; IFOSFAMIDE
- Publication
Journal of Adolescent & Young Adult Oncology, 2020, Vol 9, Issue 2, p172
- ISSN
2156-5333
- Publication type
Article
- DOI
10.1089/jayao.2019.0085