The Preliminary Study On The Relation Of Completed Cycles Of Chemotherapy And Prognosis Of Pateints With Stage ?B Osteosarcoma In Extremities

Purpose:To evaluate the impact of completed cycles of chemotherapy according to our DIA protocol on prognosis of patients with stage IIB osteosarcoma patients undergoing surgery to explore the possible role of length of chemotherapy exposure on treatment efficacy.Patients and methods:40 patients with stage IIB high-grade osteosarcoma of extremities undergoing neoadjuvant and adjuvant chemotherapy(cisplatin,doxorubicin and ifosfamide)combined with surgery from May 2008 to April 2012 in our institution,were followed up to measure disease free survival(DFS)and overall survival(OS).The completed cycles of chemotherapy and other demographic factors including sex,age,tumor site,tumor size,pathological type,surgery type,preoperative chemotherapy,serum alkaline phosphatase,lactate dehydrogenase were recorded to evaluate the prognostic value of these factors on survival by kaplan Meier method with log-rank test and mutivariate analysis with COX model.Results:With a median follow-up of 42.3 months(6-85 months),DFS and OS were 45%and 50%for all 40 patients respectively.Univariate analysis showed that patients completing five or more cycles chemotherapy had significantly higher OS than those receiving less than 5 cycles chemotherapy(72.2%vs.31.8%,p=0.015),and there were notably higher DFS and OS for patients undergoing limb salvage surgery compared with those having amputation(DFS:56%vs 26.7%,p=0.037;OS:64%vs 26.7%,p=0.004),age was also correlated with OS(p=0.042).Multivariate analysis confirmed that?5 cycles of chemotherapy was an independent prognostic factor for OS(p=0.043),surgery type was independently associated with DFS(p=0.049%).Conclusion:our study revealed that ?5 cycles of chemotherapy,patients should receive at least 5 cycles of chmotherapy according to our DIA protocol to have better survival in our study group.Further studies should be performed to evaluate whether five cycles of chemotherapy(DIA)is optimum for survival in stage ?B osteosarcoma patients and the impact of different length of chemotherapy exposure on survival in osteosarcoma patients treated with different chemotherapy protocols.