Assessment of effectiveness and complications of neoadjuvant multiagent chemotherapy in complex treatment of patients with osteosarcoma in long bones

V.S. Chyornyi, V.F. Konovalenko, V.V. Protsenko

Abstract


The paper evaluated the effectiveness of chemotherapy and its complications in 62 patients with osteosarcoma in long bones as a component of neoadjuvant multiagent chemotherapy (cisplatin 60 mg/m2 over 2 days, doxorubicin 35 mg/m2 over 2 days). Patients of the main group additionally received caffeine (1 g a day) as cisplatin modulator. The adjuvant chemotherapy was added by high-dosed methotrexate (12 g/m2), calcium folinate (15 mg/m2). The main complications after chemotherapy were alopecia, gastrointestinal toxicity, leukopenia, thrombocytopenia, depended on the scheme and the number of cycles of chemotherapy. The toxicity of chemotherapy III–IV degree (13 % of patients in the control group, 16 % patients in the study group) required intense accompanying treatment. During the caffeine administration there were observed reversible toxicity-related impairments I–II degree as short-term sleep disorders in 12.5 % , increase in heart rate of 6.2 %, nausea and vomiting in 4.4 %. In the meantime a tendency to reduction of the hematologic toxicity III–IV degree prevalence was registered: leucopenia by 4.1 %, thrombocytopenia by 3.9 %; p > 0.05. No complications or reactions led to the chemotherapy discontinuation observed. The applied methods of chemotherapy were effective (complete + partial regression by RECIST scale) in the study group (59.3 ± 3.6 %) and control group (46.2 ± 4.0 %) (p < 0.05), which allowed perform organ preservation surgery in 90.6 % and 63 % cases, respectively. The ifosfamide and second-line drugs administration in patients with low therapeutic pathomorphosis can increase the survival rate of patients.

Keywords


osteosarcoma; chemotherapy effectiveness; complications; toxicity; caffeine

References


Saeter G. European Society for Medical Oncology. ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of osteosarcoma / Saeter G. // Ann. Oncol. — 2005. — Vol. 16, № 8. — Р. 71-72.

Caffeine induces apoptosis of osteosarcoma cells by inhibiting AKT/mTOR/S6K, NF-κB and MAPK pathways / Miwa S., Sugimoto N., Yamamoto N. et al. // Anticancer research. — 2012. — Vol. 32. — P. 3643-3650.

Tomita K., Tsuchiya H. Caffeine-assisted chemotherapy and minimized tumor excisione for nonmetastatic osteosarcoma // J. Anticancer Res. — 1998. — Vol. 18. — P. 657-666.

Kawahara M., Takahashi Y., Takazawa K. et al. Coffeine Dose-dependently Potentiates the Antitumor effect of cisplatin on osteosarcomas // J. Anticancer Research. — 2008. — Vol. 28, № 3A. — P. 1681-1685.

Чорний В.С. Оптимізація комбінованого лікування хворих на остеосаркому: Автореф. дис… канд. мед. наук: 14.01.07 / Чорний В.С.; ІЕПОР ім. Р.Є. Кавецького НАН України. — К., 2011. — 20 с.

Eisenhauera E.A. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) / E.A. Eisenhauera, P. Therasseb, J. Bogaertsc [et al.] // European J. of cancer. — 2009. — Vol. 45. — P. 228-247.

Late side effects of osteosarcoma neoadjuvant chemotherapy: The experience at Rizzoli institute / A. Longhi, S. Ferrari, C. Ferrari et al. // J. Clin. Oncol. — 2006. — Vol. 24. — P. 9508-9513.

Автандилов Г.Г. Медицинская морфометрия / Г.Г. Автандилов. — М.: Медицина, 1990. — 383 с.

Gaffney R. Follow-up study of long-term survivors of osteosarcoma in the prechemotherapy era / R. Gaffney, K. Unni, F. Sim // Hum. Pathol. — 2006. — Vol. 37, № 8. — Р. 1009-1014.

Lian C.W. Study on Health-Related Quality of Life in Bone Cancer Patients / C.W. Lian, S.M. Hua, C.C. Thon // Austral-Asian Journal of Cancer. — 2013. — Vol. 12, № 2. — P. 115-121.

Черный В.С. Применение кофеина в комбинированном лечении больных остеосаркомой / Черный В.С., Бурьянов А.А., Тарасова Т.А., Проценко В.В. // Літопис травматології та ортопедії. — 2011. — № 1–2. — С. 102-105.

Kimura H. Caffeine-potentiated chemotherapy for metastatic osteosarcoma / Kimura H., Tsuchiya H., Shirai T. et al. // J. Orthop. Sci. — 2009 Sep. — Vol. 14, № 5. — P. 556-65.




DOI: https://doi.org/10.22141/1608-1706.2.18.2017.102554

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