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Doxorubicin and cisplatin with granulocyte colony-stimulating factor as adjuvant chemotherapy for osteosarcoma: phase II trail of the European Osteosarcoma Intergroup

Lookup NU author(s): Dr Ruth Bridgewater, Emeritus Professor Alan Craft

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Abstract

Purpose: This report describes the toxicity and feasibility of administering doxorubicin (DOX) and cisplatin (CDDP) at 2-week intervals with granulocyte colony-stimulating factor (G-CSF) to patients with asteosarcoma and the compatibility of this regimen with endoprosthetic surgery performed after three cycles. Patients and Methods: Twenty-four patients with biopsy-proven-osteosarcoma were treated with three preoperative cycles of DOX 25 mg/m(2)/d on days 1 to 3 and CDDP 100 mg/m(2) on day 1 with G-CSF 5 mu g/kg/d on days 4 to 14. Surgery was scheduled at week 6 to be followed by three further cycles of chemotherapy at 2-week intervals. Results: Two-week chemotherapy was feasible, but delays and dose reductions only allowed 74% and 78% of the intended dose-intensity of DOX and CDDP to be administered. Thrombocytopenia accounted for 50% of delays. Significant toxicity included neutropenic sepsis, severe mucositis, prolonged nausea and vomiting, and electrolyte disturbances. Twenty-one limb salvage procedures and one amputation were performed. there were eight episodes of excessive perioperative bleeding. Conclusion: Intensive 2-week chemotherapy with intercurrent surgery is feasible and allows a greater dose-intensity of chemotherapy to be administered compared with the same regimen administered at 3-week intervals without G-CSF. The toxicity is considerable, but manageable. (C) 1994 by American Society of Clinical Oncology.

Publication metadata

Author(s): Ornadel, D., Souhami, R. L., Whelan, J., Nooy, M., Deelvira, C. R., Pringle, J., Lewis, I., Steward, W. P., George, R., Bridgewater, J., Wierzbicki, R., Craft, A. W.

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Oncology

Year: 1994

Volume: 12

Issue: 9

Pages: 1842-1848

Print publication date: 01/09/1994

ISSN (print): 0732-183X

ISSN (electronic): 1527-7755

PubMed id: 7521906

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