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January 1, 1984Cancer Investigation

Primary Osteogenic Sarcoma of the Femur: A Model for the Use of Preoperative Chemotherapy in High Risk Malignant Tumors

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Why the study?

Does the addition of preoperative chemotherapy protocols improve continuous disease-free survival in young patients with high-risk primary osteogenic sarcoma of the femur?

Population

100 patients aged 21 years or less with fully malignant primary osteogenic sarcoma of the femur and no…

Comparison

Preoperative chemotherapy protocols: T-4, T-7… vs Comparison between different sequential…

Design

Cohort

Follow-up

Minimum >7 years for T-4, >5 years for T-7, and median 33…

Authors

GRGerald RosenHospital for Special SurgeryBCBrenda CaparrosMemorial Sloan Kettering Cancer CenterSGSusan GroshenUniversity of Southern California

Discussion

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Overview

May support sequential chemotherapy intensification in high-risk femoral osteogenic sarcoma; leaves open randomized confirmation.

Structured PICO

Does the addition of preoperative chemotherapy protocols improve continuous disease-free survival in young patients with high-risk primary osteogenic sarcoma of the femur?

P
Population
100 patients aged 21 years or less with fully malignant (Grade III-IV/IV) primary osteogenic sarcoma of the femur and no metastases, treated from November 1973 through November 1981.
I
Intervention
Preoperative chemotherapy protocols: T-4 (high dose methotrexate [HDMTX] with leucovorin rescue, cyclophosphamide, and adriamycin), T-7 (HDMTX 12 g/m2 for prepubescent patients, bleomycin, cyclophosphamide, and dactinomycin), or T-10 (same as T-7, plus cisplatinum 120 mg/m2 with adriamycin 30 mg/m2/day for two consecutive days for non-complete responders).
C
Comparator
Comparison between different sequential chemotherapy protocols (T-4 vs T-7 vs T-10).
O
Outcome
Continuous disease-free (CNED) survivalhard clinical

Sequential intensification of preoperative chemotherapy protocols, including the addition of cisplatinum for non-responders, substantially improved continuous disease-free survival in young patients with osteogenic sarcoma of the femur.

Cite This Study

Rosen et al. (1984) studied this question.

synapsesocial.com/papers/6a86663be3ff5bf5642ed17dhttps://doi.org/10.3109/07357908409104370
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Chemotherapy,en bloc resection, and prosthetic bone replacement in the treatment of osteogenic sarcoma1976 · 357 citations
  2. 2Preoperative chemotherapy for osteogenic sarcoma:Selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy1982 · 1,102 citations
  3. 3Study of Adjuvant Chemotherapy in Osteogenic Sarcoma1975 · 32 citations
  4. 4High-dose methotrexate with citrovorum factor rescue and adriamycin in childhood osteogenic sarcoma1974 · 172 citations
  5. 5Primary osteogenic sarcoma. The rationale for preoperative chemotherapy and delayed surgery1979 · 595 citations