Neoadjuvant Chemotherapy Combined With Limb Salvage Surgery For Treatment Of Primary Limbs Osteosarcoma Clinical Outcome Study

Objective: To evaluate the efficacy of new adjuvant chemotherapy in combination with limb salvage surgery for treatment of primary limbs of osteosarcoma. To analysis the difference of the two kind surgery's survival rate and discuss the related problems.Methods: We treated 32 patients adults suffered primary limbs of osteosarcoma from 2003 to 2008. There were 18 males and 14 females. The age was 15~70. One patient presented with pathologic fracture. We report the results of treating 32 adults (age 18-70 years) diagnosed with nonmetastatic extremity osteosarcoma. Sites of involvement included the distant femur (12), proximal tibia (14), proximal femur (3), proximal fibula (2) proximal radius (1). The majority of tumors (23) were 10 cm or smaller; 9 patients had tumors greater than 10 cm.32 patients were divided into two groups:One group is composed by 17 patients, preoperative chemotherapy consisted of intravenous doxorubicin(60-80mg/m )followed by intraarterial cisplatinum( 120mg/m ) administered repetitively every 3 weeks for two cycles, After resection,these patients underwent treatment with the same agents for four cycles;the other group is composed by 15 patients, preoperative chemotherapy consisted of intravenous doxorubicin (60-80mg/m2 ) and cisplatinum( 120mg/m2) administered repetitively every 3 weeks for two cycles, After amputation,these patients underwent treatment with the same agents for four cycles.Results: 32 patients were obtained follow-up . The follow-up time is 3 months - 60 months, average 37 months . In limb-salvage surgery group,the proportion of patients with 3-year overall survival was 76%,local recurrence rate was 6%; In amputation group,the proportion of patients with 3-year overall survival was 67%, local recurrence rate was 7%.There was no significant difference between the two groups in the survival rate by log-rank test.(P>0.05, means no significant difference). By bone and soft tissue tumors Society scoring system in 1993(MSTS), In limb-salvage surgery group is 21.4, In amputation group is 12.Conclusion: We designed a neoadjuvant chemotherapy protocol using combined intraarterial and intravenous agents to treat osteosarcoma,this chemotherapy Protocolused in PreoPerative and PostoPerative can Provide a good clinical aPPlication...