Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups

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Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups. / Ferrari, S; Smeland, S; Mercuri, M; Bertoni, F; Longhi, A; Ruggieri, P; Alvegård, Thor; Picci, P; Capanna, R; Bernini, G; Muller, C; Tienghi, A; Wiebe, Thomas; Comandone, A; Bohling, T; Del Prever, AB; Brosjo, O; Bacci, G; Saeter, G.

In: Journal of Clinical Oncology, Vol. 23, No. 34, 2005, p. 8845-8852.

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Ferrari, S, Smeland, S, Mercuri, M, Bertoni, F, Longhi, A, Ruggieri, P, Alvegård, T, Picci, P, Capanna, R, Bernini, G, Muller, C, Tienghi, A, Wiebe, T, Comandone, A, Bohling, T, Del Prever, AB, Brosjo, O, Bacci, G & Saeter, G 2005, 'Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups', Journal of Clinical Oncology, vol. 23, no. 34, pp. 8845-8852. https://doi.org/10.1200/JCO.2004.00.5785

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Ferrari S, Smeland S, Mercuri M, Bertoni F, Longhi A, Ruggieri P, Alvegård T, Picci P, Capanna R, Bernini G, Muller C, Tienghi A, Wiebe T, Comandone A, Bohling T, Del Prever AB, Brosjo O, Bacci G, Saeter G. 2005. Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups. Journal of Clinical Oncology. 23(34):8845-8852. https://doi.org/10.1200/JCO.2004.00.5785

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Ferrari, S ; Smeland, S ; Mercuri, M ; Bertoni, F ; Longhi, A ; Ruggieri, P ; Alvegård, Thor ; Picci, P ; Capanna, R ; Bernini, G ; Muller, C ; Tienghi, A ; Wiebe, Thomas ; Comandone, A ; Bohling, T ; Del Prever, AB ; Brosjo, O ; Bacci, G ; Saeter, G. / Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 34. pp. 8845-8852.

RIS

TY - JOUR

T1 - Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: A joint study by the Italian and Scandinavian Sarcoma Groups

AU - Ferrari, S

AU - Smeland, S

AU - Mercuri, M

AU - Bertoni, F

AU - Longhi, A

AU - Ruggieri, P

AU - Alvegård, Thor

AU - Picci, P

AU - Capanna, R

AU - Bernini, G

AU - Muller, C

AU - Tienghi, A

AU - Wiebe, Thomas

AU - Comandone, A

AU - Bohling, T

AU - Del Prever, AB

AU - Brosjo, O

AU - Bacci, G

AU - Saeter, G

PY - 2005

Y1 - 2005

N2 - Purpose To explore the effect of high-dose ifosfamide in first-line treatment for patients <= 40 years of age with nonmetastatic osteosarcoma of the extremity. Patients and Methods From March 1997 to September 2000, 182 patients were evaluated. Primary treatment consisted of two blocks of high-dose ifosfamide (15 g/m(2)), methotrexate (12 g/m(2)), cisplatin (120 mg/m(2)), and doxorubicin (75 mg/m(2)). Postoperatively, patients received two cycles of doxorubicin (go mg/m(2)), and three cycles each of high-dose ifosfamide, methotrexate, and cisplatin (120 to 150 mg/m(2)). Granulocyte colony-stimulating factor support was mandatory after the high-dose ifosfamide/cisplatin/doxorubicin combination. Results No disease progression was recorded during primary chemotherapy, 164 patients (92%) underwent limb-salvage surgery, four patients (2%) underwent rotation plasty, and 11 patients (6%) had limbs amputated. Three (1.6%) patients died as a result of treatment-related toxicity, and one died as a result of pulmonary embolism after pathologic fracture. Grade 4 neutropenia and thrombocytopenia followed 52% and 31% of all courses, respectively, and mild to severe nephrotoxicity was recorded in 19 patients (10%). The median received dose-intensity compared with protocol was 0.82. With a median follow-up of 55 months, the 5-year probability of event-free survival was 64% (95% CI 57% to 71%) and overall survival was 77% (95% CI 67% to 81%), whereas seven patients (4%) experienced local recurrence. Conclusion The addition of high-dose ifosfamide to methotrexate, cisplatin, and doxorubicin in the preoperative phase is feasible, but with major renal and hematologic toxicities, and survival rates similar to those obtained with four-drug regimens using standard-dose ifosfamide. Italian Sarcoma Group/Scandinavian Sarcoma Group study I showed that in a multicenter setting, more than 90% of patients with osteosarcoma of the extremity can undergo conservative surgery.

AB - Purpose To explore the effect of high-dose ifosfamide in first-line treatment for patients <= 40 years of age with nonmetastatic osteosarcoma of the extremity. Patients and Methods From March 1997 to September 2000, 182 patients were evaluated. Primary treatment consisted of two blocks of high-dose ifosfamide (15 g/m(2)), methotrexate (12 g/m(2)), cisplatin (120 mg/m(2)), and doxorubicin (75 mg/m(2)). Postoperatively, patients received two cycles of doxorubicin (go mg/m(2)), and three cycles each of high-dose ifosfamide, methotrexate, and cisplatin (120 to 150 mg/m(2)). Granulocyte colony-stimulating factor support was mandatory after the high-dose ifosfamide/cisplatin/doxorubicin combination. Results No disease progression was recorded during primary chemotherapy, 164 patients (92%) underwent limb-salvage surgery, four patients (2%) underwent rotation plasty, and 11 patients (6%) had limbs amputated. Three (1.6%) patients died as a result of treatment-related toxicity, and one died as a result of pulmonary embolism after pathologic fracture. Grade 4 neutropenia and thrombocytopenia followed 52% and 31% of all courses, respectively, and mild to severe nephrotoxicity was recorded in 19 patients (10%). The median received dose-intensity compared with protocol was 0.82. With a median follow-up of 55 months, the 5-year probability of event-free survival was 64% (95% CI 57% to 71%) and overall survival was 77% (95% CI 67% to 81%), whereas seven patients (4%) experienced local recurrence. Conclusion The addition of high-dose ifosfamide to methotrexate, cisplatin, and doxorubicin in the preoperative phase is feasible, but with major renal and hematologic toxicities, and survival rates similar to those obtained with four-drug regimens using standard-dose ifosfamide. Italian Sarcoma Group/Scandinavian Sarcoma Group study I showed that in a multicenter setting, more than 90% of patients with osteosarcoma of the extremity can undergo conservative surgery.

U2 - 10.1200/JCO.2004.00.5785

DO - 10.1200/JCO.2004.00.5785

M3 - Article

VL - 23

SP - 8845

EP - 8852

JO - Journal of clinical oncology : official journal of the American Society of Clinical Oncology

T2 - Journal of clinical oncology : official journal of the American Society of Clinical Oncology

JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology

SN - 1527-7755

IS - 34

ER -