Effect of dose intensity of methotrexate, doxorubicin, and ifosfamide on the prognosis of patients with osteosarcoma

Yoichiro Uchida, Toshihumi Ozaki, Akira Kawai, Toshiyuki Kunisada, Tomoyuki Dan'ura, Noriko Naito, Hajime Inoue

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. The prognosis of patients with osteosarcoma has improved due to the introduction of systemic chemotherapy. The current study tried to identify the effect of each anti-tumor drug on the prognosis of patients with osteosarcoma. Methods. The records of 29 patients with osteosarcoma who received systemic chemotherapy were retrospectively analyzed. All tumors were classified as stage IIB (Enneking's surgical stage) and were located around the knee joint or more distal areas. The histologic response to preoperative chemotherapy was determined in 20 patients: 9 patients had grade 1, 4 grade 2, 5 grade 3, and 2 grade 4. The mean follow-up period was 102 months. Results. The 5-year overall survival and relapse-free survival (RFS) in the 29 patients was 47.7% and 41.4%, respectively. The 5-year RFS for the 7 good responders (grade 3 and 4) was 85.7%, and that for the 13 poor responders (grade 1 and 2) was 23.1% (P = 0.008). The mean preoperative dose intensity (DI) of methotrexate (MTX) for good responders was significantly higher than that for poor responders (P = 0.028). In 23 patients who received MTX and doxorubicin (ADR) but not ifosfamide (IFOS), the DI of MTX significantly influenced the RFS (P = 0.0128). In the 13 poor responders, 6 of whom received IFOS, the DI of IFOS and ADR significantly influenced RFS (P = 0.0112, 0.0395). Conclusion. The preoperative DI of MTX was related to the histologic response rate. The DI of MTX was significantly associated with the patients' RFS. In poor responders, the DI of IFOS and ADR influenced the patients' RFS.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalInternational Journal of Clinical Oncology
Volume4
Issue number1
DOIs
Publication statusPublished - Feb 1999

Fingerprint

Ifosfamide
Osteosarcoma
Methotrexate
Doxorubicin
Survival
Recurrence
Drug Therapy
Knee Joint
Neoplasms

Keywords

  • Chemotherapy
  • Dose intensity
  • Osteosarcoma
  • Prognosis

ASJC Scopus subject areas

  • Oncology

Cite this

Effect of dose intensity of methotrexate, doxorubicin, and ifosfamide on the prognosis of patients with osteosarcoma. / Uchida, Yoichiro; Ozaki, Toshihumi; Kawai, Akira; Kunisada, Toshiyuki; Dan'ura, Tomoyuki; Naito, Noriko; Inoue, Hajime.

In: International Journal of Clinical Oncology, Vol. 4, No. 1, 02.1999, p. 36-40.

Research output: Contribution to journalArticle

@article{64fd5d9706c6435aa102f52b4db46a97,
title = "Effect of dose intensity of methotrexate, doxorubicin, and ifosfamide on the prognosis of patients with osteosarcoma",
abstract = "Background. The prognosis of patients with osteosarcoma has improved due to the introduction of systemic chemotherapy. The current study tried to identify the effect of each anti-tumor drug on the prognosis of patients with osteosarcoma. Methods. The records of 29 patients with osteosarcoma who received systemic chemotherapy were retrospectively analyzed. All tumors were classified as stage IIB (Enneking's surgical stage) and were located around the knee joint or more distal areas. The histologic response to preoperative chemotherapy was determined in 20 patients: 9 patients had grade 1, 4 grade 2, 5 grade 3, and 2 grade 4. The mean follow-up period was 102 months. Results. The 5-year overall survival and relapse-free survival (RFS) in the 29 patients was 47.7{\%} and 41.4{\%}, respectively. The 5-year RFS for the 7 good responders (grade 3 and 4) was 85.7{\%}, and that for the 13 poor responders (grade 1 and 2) was 23.1{\%} (P = 0.008). The mean preoperative dose intensity (DI) of methotrexate (MTX) for good responders was significantly higher than that for poor responders (P = 0.028). In 23 patients who received MTX and doxorubicin (ADR) but not ifosfamide (IFOS), the DI of MTX significantly influenced the RFS (P = 0.0128). In the 13 poor responders, 6 of whom received IFOS, the DI of IFOS and ADR significantly influenced RFS (P = 0.0112, 0.0395). Conclusion. The preoperative DI of MTX was related to the histologic response rate. The DI of MTX was significantly associated with the patients' RFS. In poor responders, the DI of IFOS and ADR influenced the patients' RFS.",
keywords = "Chemotherapy, Dose intensity, Osteosarcoma, Prognosis",
author = "Yoichiro Uchida and Toshihumi Ozaki and Akira Kawai and Toshiyuki Kunisada and Tomoyuki Dan'ura and Noriko Naito and Hajime Inoue",
year = "1999",
month = "2",
doi = "10.1007/s101470050021",
language = "English",
volume = "4",
pages = "36--40",
journal = "International Journal of Clinical Oncology",
issn = "1341-9625",
publisher = "Springer Japan",
number = "1",

}

TY - JOUR

T1 - Effect of dose intensity of methotrexate, doxorubicin, and ifosfamide on the prognosis of patients with osteosarcoma

AU - Uchida, Yoichiro

AU - Ozaki, Toshihumi

AU - Kawai, Akira

AU - Kunisada, Toshiyuki

AU - Dan'ura, Tomoyuki

AU - Naito, Noriko

AU - Inoue, Hajime

PY - 1999/2

Y1 - 1999/2

N2 - Background. The prognosis of patients with osteosarcoma has improved due to the introduction of systemic chemotherapy. The current study tried to identify the effect of each anti-tumor drug on the prognosis of patients with osteosarcoma. Methods. The records of 29 patients with osteosarcoma who received systemic chemotherapy were retrospectively analyzed. All tumors were classified as stage IIB (Enneking's surgical stage) and were located around the knee joint or more distal areas. The histologic response to preoperative chemotherapy was determined in 20 patients: 9 patients had grade 1, 4 grade 2, 5 grade 3, and 2 grade 4. The mean follow-up period was 102 months. Results. The 5-year overall survival and relapse-free survival (RFS) in the 29 patients was 47.7% and 41.4%, respectively. The 5-year RFS for the 7 good responders (grade 3 and 4) was 85.7%, and that for the 13 poor responders (grade 1 and 2) was 23.1% (P = 0.008). The mean preoperative dose intensity (DI) of methotrexate (MTX) for good responders was significantly higher than that for poor responders (P = 0.028). In 23 patients who received MTX and doxorubicin (ADR) but not ifosfamide (IFOS), the DI of MTX significantly influenced the RFS (P = 0.0128). In the 13 poor responders, 6 of whom received IFOS, the DI of IFOS and ADR significantly influenced RFS (P = 0.0112, 0.0395). Conclusion. The preoperative DI of MTX was related to the histologic response rate. The DI of MTX was significantly associated with the patients' RFS. In poor responders, the DI of IFOS and ADR influenced the patients' RFS.

AB - Background. The prognosis of patients with osteosarcoma has improved due to the introduction of systemic chemotherapy. The current study tried to identify the effect of each anti-tumor drug on the prognosis of patients with osteosarcoma. Methods. The records of 29 patients with osteosarcoma who received systemic chemotherapy were retrospectively analyzed. All tumors were classified as stage IIB (Enneking's surgical stage) and were located around the knee joint or more distal areas. The histologic response to preoperative chemotherapy was determined in 20 patients: 9 patients had grade 1, 4 grade 2, 5 grade 3, and 2 grade 4. The mean follow-up period was 102 months. Results. The 5-year overall survival and relapse-free survival (RFS) in the 29 patients was 47.7% and 41.4%, respectively. The 5-year RFS for the 7 good responders (grade 3 and 4) was 85.7%, and that for the 13 poor responders (grade 1 and 2) was 23.1% (P = 0.008). The mean preoperative dose intensity (DI) of methotrexate (MTX) for good responders was significantly higher than that for poor responders (P = 0.028). In 23 patients who received MTX and doxorubicin (ADR) but not ifosfamide (IFOS), the DI of MTX significantly influenced the RFS (P = 0.0128). In the 13 poor responders, 6 of whom received IFOS, the DI of IFOS and ADR significantly influenced RFS (P = 0.0112, 0.0395). Conclusion. The preoperative DI of MTX was related to the histologic response rate. The DI of MTX was significantly associated with the patients' RFS. In poor responders, the DI of IFOS and ADR influenced the patients' RFS.

KW - Chemotherapy

KW - Dose intensity

KW - Osteosarcoma

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=0033019486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033019486&partnerID=8YFLogxK

U2 - 10.1007/s101470050021

DO - 10.1007/s101470050021

M3 - Article

AN - SCOPUS:0033019486

VL - 4

SP - 36

EP - 40

JO - International Journal of Clinical Oncology

JF - International Journal of Clinical Oncology

SN - 1341-9625

IS - 1

ER -