Abstract
Background: This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma. Methods: The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated. Results: For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances. Conclusions: Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction.
Original language | English (US) |
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Pages (from-to) | 1736-1744 |
Number of pages | 9 |
Journal | Cancer |
Volume | 117 |
Issue number | 8 |
DOIs | |
State | Published - Apr 15 2011 |
Externally published | Yes |
Keywords
- bisphosphonates
- chemotherapy
- endoprosthetic reconstruction
- limb-sparing surgery
- osteosarcoma
- pamidronate
ASJC Scopus subject areas
- Oncology
- Cancer Research