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Complex treatment of metachronous metastases of osteosarcoma with or
without preoperative chemotherapy: comparative results
Abstract ID : 1272
Submitted by : Anatolii Diedkov the 2016-02-14 09:39:02
Category : Others
Typology : Poster
Status : Validated
Authorisation to disclose : Yes/Oui
------------------------------------Background: Lung metastasis development after treatment is a negative prognostic factor for the long-term results in
patients with osteosarcoma. The main treatment method for such category of patients is surgical removal of all
metastatic lesions. This approach helps to achieve a quite high survival rate. There is no doubt among the majority of
professionals about obligation of chemotherapy, however the need of preoperative chemotherapy is still under
consideration.
Aim: To determine the preferable treatment regimen for patients with metastatic osteosarcoma.
Methods: 46 patients (mean age – 22,4 years; 17 women and 29 men) with metachronous metastases of osteosarcoma
were considered fully operable subsequent to the results of CT in National Cancer Institute (Kyiv, Ukraine) 2010 to 2015.
Metastases were detected between 6 and 38 months after the treatment (median - 22.3 months). The patients were
assigned to 2 treatment groups. First group (n = 23; 50.0 %) underwent preoperative and postoperative chemotherapy:
ifosfamide 9 g/m2, etoposide 150 mg/m2 and carboplatin 450 mg/m2. Second group (n = 23; 50.0 %) received the same
scheme of postoperative chemotherapy only. The survival rate was estimated using Kaplan-Meier analysis. Mean
monitoring time was 20 months (6 to 100).
Results: 16 patients (69,6%) underwent surgery, 7 patients (30,4%) received radiotherapy (15 Gray on each lung) due to
disease progression in 1 group. 23 patients (100%) were operated in 2nd group. Event free survival rate was 28,4 % in
preoperative and postoperative chemotherapy group, and 35,8 % in postoperative chemotherapy group, median survival
was 14,2 and 18,3 months, respectively (without statistical significant difference). The chemotherapy toxicity was
assessed according to Common Terminology Criteria for Adverse Events (CTCAE v.3.0). 26,5% of 1st group and 15,3%
of the 2nd group was observed hematological toxicity grade 4 .
Conclusion: Preoperative chemotherapy in metachronous metastases of osteosarcoma has shown no benefits on
survival. We suggest that preferable treatment strategy for such patients is surgical treatment followed by chemotherapy.
The acceptable toxicity allows to implement the planned treatment without deterioration of oncological outcomes.
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Authors
Anatolii Diedkov 1, Pavlo Kovalchuk 1, Sergiy Boichuk 1, Viktor Kostyuk 1, Tatiana Tarasova 1,
1. Orthopedic Oncology, National Cancer Institute, Kiev, UKRAINE
Authors (raw format)
Diedkov Anatolii - email : [email protected] Institution : National Cancer Institute Department : Orthopedic
Oncology City : Kiev Country : UKRAINE Speaker : Yes
Kovalchuk Pavlo - email : [email protected] Institution : National Cancer Institute Department : Orthopedic
Oncology City : Kiev Country : UKRAINE Speaker : No
Boichuk Sergiy - email : [email protected] Institution : National Cancer Institute Department : Orthopedic Oncology
City : Kiev Country : UKRAINE Speaker : No
Kostyuk Viktor - email : [email protected] Institution : National Cancer Institute Department : Orthopedic Oncology
City : Kiev Country : UKRAINE Speaker : No
Tarasova Tatiana - email : [email protected] Institution : National Cancer Institute Department : Orthopedic
Oncology City : Kiev Country : UKRAINE Speaker : No