Effect of Cisplatin Arterial Infusion (CAI) on Primary Nonmetastatic Pelvic Osteosarcoma: A Preliminary Study
Received 29 November 2020
Accepted for publication 28 January 2021
Published 15 February 2021 Volume 2021:13 Pages 1491—1503
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Eileen O'Reilly
Xuantao Hu, Xia Chen, Tao Li, Zicheng Liu, Xiaoning Guo, Zhengxiao Ouyang
Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of China
Correspondence: Xiaoning Guo; Zhengxiao Ouyang
Department of Orthopedics, The Second Xiangya Hospital of Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People’s Republic of China
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Purpose: The critical role of arterial infusion chemotherapy in the multimodal treatment of extremity bone cancer has been investigated extensively, but few studies have focused on pelvic osteosarcoma. Therefore, we attempted to evaluate the clinical significance of arterial infusion chemotherapy in the treatment of pelvic osteosarcoma.
Patients and Methods: We combined a cisplatin arterial infusion regimen with multidrug systematic chemotherapy as a neoadjuvant protocol for the treatment of pelvic osteosarcoma. The course number and dosage of cisplatin arterial infusion were adjusted to achieve a maximal tumor response evaluated by contrast-enhanced MRI per RECIST 1.1. Good responders received the same systematic combination for postoperative chemotherapy, and poor responders received second-line therapy. Twelve patients with nonmetastatic high-grade pelvic osteosarcoma were included. Survival, chemotherapy response and adverse events data were analyzed.
Results: The mean follow-up period was 56.1 months. Four patients died of refractory tumor progression, and 1 patient with local recurrence had no evidence of disease for 27 months after receiving secondary amputation and resection. Kaplan-Meier survival analysis demonstrated a 57.8% overall survival and 52.5% event-free survival rate at 5 years. Eight of 12 patients had a > 90% tumor necrosis rate according to histopathologic examinations. The rates of local adverse events were lower than those reported for extremity osteosarcoma.
Conclusion: Our study initially indicated that the cisplatin arterial infusion regimen was a potential therapy with good tolerance in the treatment of pelvic osteosarcoma.
Keywords: osteosarcoma, pelvis, cisplatin, arterial infusion, chemotherapy toxicity
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