Neoadjuvant chemotherapy with high-dose ifosfamide, doxorubicin and cisplatin in nonmetastatic osteosarcoma of the extremity

Osteosarcoma is commonly treated with doxorubicin, cisplatin and methotrexate. Patients that do not respond well to these treatments tend to be given ifosfamide.

The study presented at the 2004 American Society of Clinical Oncology annual meeting, was carried out over 3 years on 26 patients with newly diagnosed and previously untreated nonmetastatic (stage IIB) osteosarcoma of the extremities.Patients were given 90 mg/m2 of doxorubicin for cycles 1 and 3, 120 mg/m2 of cisplatin for cycles 1 and 3 and a continuous infusion of 15 g /m2 of ifosfamide over cycles 2 and 4.After these 4 courses of treatment patients underwent limb-saving surgery.Post-operatively, patients were given doxorubicin and cisplatin, ifosfamide and methotrexate.Of the 26 patients studied, 20 (77%) were disease free, 3 showed no evidence of disease after pulmonary metastasectomy, 2 were alive with the disease and 1 patient died. Local recurrence was only seen in 1 patient. In the follow-up to the study, after 3 years, 84% showed event-free survival and after 5 years, 79% showed event-free survival. Researchers concluded that neoadjuvant chemotherapy including ifosfamide shows good survival rates.