Highly effective reduced toxicity dose-intensive pilot protocol for non-metastatic limb osteogenic sarcoma (SCOS 89)

Purpose Aggressive chemotherapy protocols for non-metastatic limb osteosarcoma have improved histological response without affecting prognosis. This study evaluated the toxicity and outcome of a dose-intensive, high-dose 3- to 5-drug pilot protocol, SCOS 89. Methods The cohort included 26 patients (...

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Bibliographic Details
Published in:Cancer chemotherapy and pharmacology 2015-11, Vol.76 (5), p.909-916
Main Authors: Shkalim-Zemer, Vered, Ash, Shifra, Toledano, Helen, Kollender, Yehuda, Issakov, Josephine, Yaniv, Isaac, Cohen, Ian J.
Format: Article
Language:English
Subjects:
Adolescent
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bone Neoplasms - drug therapy
Bone Neoplasms - surgery
Cancer Research
Child
Cisplatin - administration & dosage
Cisplatin - adverse effects
Combined Modality Therapy
Disease-Free Survival
Doxorubicin - administration & dosage
Doxorubicin - adverse effects
Drug Substitution
Etoposide - administration & dosage
Etoposide - adverse effects
Female
Follow-Up Studies
Hearing Loss - chemically induced
Humans
Ifosfamide - administration & dosage
Ifosfamide - adverse effects
Kidney Diseases - chemically induced
Leucovorin - administration & dosage
Leucovorin - adverse effects
Male
Medicine
Medicine & Public Health
Methotrexate - administration & dosage
Methotrexate - adverse effects
Oncology
Original Article
Osteosarcoma - drug therapy
Osteosarcoma - surgery
Pharmacology/Toxicology
Pilot Projects
Stroke Volume - drug effects
Survival Rate
Treatment Outcome
Young Adult
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Summary:Purpose Aggressive chemotherapy protocols for non-metastatic limb osteosarcoma have improved histological response without affecting prognosis. This study evaluated the toxicity and outcome of a dose-intensive, high-dose 3- to 5-drug pilot protocol, SCOS 89. Methods The cohort included 26 patients (14 male; ages 6.5–22 years) with non-metastatic limb osteosarcoma treated at a tertiary pediatric medical center between 1989 and 2013. Preoperatively, patients received two courses of once-weekly pulses of high-dose methotrexate (12–30 g/m 2 ) for 2 weeks; doxorubicin (90 mg/m 2 ) with dexrazoxane, combined with cisplatin (200 mg/m 2 ), was added in week 3. Following methotrexate, 760 mg/m 2 of folinic acid was administered. Postoperative chemotherapy was continued to a total of 14 courses of methotrexate, doxorubicin (up to a total dose of 360 mg/m 2 ), and cisplatin (up to a total dose of 560 mg/m 2 ). If toxicity occurred or
ISSN:0344-5704
1432-0843
DOI:10.1007/s00280-015-2865-x