Intensification of preoperative chemotherapy for osteogenic sarcoma: Results of the Memorial Sloan-Kettering (T12) protocol Journal Article


Authors: Meyers, P. A.; Gorlick, R.; Heller, G.; Casper, E.; Lane, J.; Huvos, A. G.; Healey, J. H.
Article Title: Intensification of preoperative chemotherapy for osteogenic sarcoma: Results of the Memorial Sloan-Kettering (T12) protocol
Abstract: Purpose: It has been observed previously in osteosarcoma (OS) that the degree of necrosis of the resected primary tumor following a period of preoperative chemotherapy is predictive of subsequent event-free survival (EFS). The aim of this study was to determine if more intensive preoperative chemotherapy would increase the proportion of patients with a good histologic response and improve EFS. Patients and Methods: Seventy-three patients with OS were treated at Memorial-Sloan Kettering Cancer Center (MSKCC) on the T12 protocol between 1986 and 1993. Patients were randomized between therapy based on the T10 protocol and therapy with more intensive preoperative chemotherapy. The more intensive preoperative regimen consisted of two courses of cisplatin (CDDP) and doxorubicin (DOX) in addition to the usual preoperative regimen of high-dose methotrexate (HD MTX) and bleomycin, cyclophosphamide, and dactinomycin (BCD). Results: The regimen with more intensive preoperative chemotherapy achieved a modest increase in the proportion of patients with a good histologic response (44% with a grade III or IV histologic response v 37% in the control arm, 33% with grade IV histologic response v 13% in the control arm). EFS continued to correlate with histologic response. The actuarial 5-year EFS in patients with localized disease was 78% for the regimen with more intensive preoperative chemotherapy and 73% for the control arm. Conclusion: Despite modest increases in the proportion of patients with good histologic response with intensified preoperative chemotherapy, no improvement in EFS was observed.
Keywords: osteosarcoma; adolescent; adult; cancer chemotherapy; cancer survival; child; preschool child; school child; treatment outcome; bone neoplasms; child, preschool; disease-free survival; cancer surgery; major clinical study; histopathology; cisplatin; doxorubicin; disease classification; chemotherapy, adjuvant; methotrexate; antineoplastic combined chemotherapy protocols; cyclophosphamide; necrosis; time factors; dactinomycin; bleomycin; preoperative treatment; tumor necrosis; humans; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 16
Issue: 7
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1998-07-01
Start Page: 2452
End Page: 2458
Language: English
PUBMED: 9667263
PROVIDER: scopus
DOI: 10.1200/JCO.1998.16.7.2452
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. Glenn Heller
    295 Heller
  2. Richard G Gorlick
    120 Gorlick
  3. Paul Meyers
    244 Meyers
  4. John H Healey
    374 Healey
  5. Ephraim S Casper
    57 Casper
  6. Andrew G Huvos
    202 Huvos