Does intensified chemotherapy increase survival outcomes of osteosarcoma patients? A meta-analysis

Abstract

Study DesignMeta-analysis.BackgroundAlthough some new insights have been offered for clinical and scientific relevance, minor progress has been made in osteosarcoma treatment after a dramatic survival improvement in the late 1980s with the addition of chemotherapy to surgery. Intensified chemotherapy strategies have been suggested to increase the survival rate of patients with osteosarcoma. We performed this study to access whether intensified chemotherapy strategiesincreased survival outcomes of osteosarcoma patients compared with conventional chemotherapy strategies.MethodsMEDLINE/PubMed, EMBASE, BIOSIS Previews, and Cochrane Library were searched from database set up to October2016. Randomized controlled trials (RCTs) and comparative clinical trials (CCTs) on intensified versus conventional chemotherapy strategies for osteosarcoma patients met the inclusion criteria, and the methodological quality standard were retrieved and reviewed. Data on participant characteristics, interventions, follow-up period, and outcomes were extracted from the included studies and analyzed by Review Manager 5.3.Results12 studies (8 RCTs and 4CCT) involving 4112 patients were selected. There were no significant differences between intensified and conventional chemotherapy strategies group in 3-year event-free survival (OR, 1.01; 95% CI, [0.74–1.37]; P = 0.97), 5-year event-free survival (OR, 1.00; 95% CI, [0.86–1.17]; P = 0.97), and 5-year overall survival (OR, 1.04; 95% CI, [0.87–1.26]; P = 0.64), and good histologic response to preoperative chemotherapy (OR, 1.12; 95% CI, [0.78–1.60]; P = 0.55). Pooled analysis of local recurrence rate showed that local recurrence rate was significantly decreased in the intensified group compared with that in the conventional group (OR, 0.60; 95% CI, [0.42–0.85]; P = 0.004).ConclusionsIntensified chemotherapy might not be a preferred treatment for all of the osteosarcoma patients.

Prognostic significance of maximum standardized uptake value on 18 F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in bone sarcomas

“…In the literature, the five-year overall survival rate for bone sarcoma is 63.6%. [13] In our study, we concluded that five-year survival rate for bone sarcoma is 79±0.08%.…”

A newly revised pivot knee prosthesis for peri-knee malignant bone destruction tumor management

“…Technological development and improved understanding of the mechanism of carcinoma progression, together with improved staging and classi cation of the carcinoma could make some important impacts on treatment and prognosis. Presently, radically removing the tumor [4], bone grafting [18], and prosthesis arthroplasty [3,19] coupled with preoperative and postoperative chemotherapy [7] have all established advantages, although de ciencies exist in each method. One of the merits of this newly revised pivot knee prosthesis is that it could preserve the knee joint function, which may make the patient live more conveniently and con dently.…”

“…Preoperative chemotherapy can kill tumor cells effectively and shrink tumor size, which may provide a favorable environment for subsequent surgical intervention, especially for some carcinomas which are sensitive to chemotherapy, such as Ewing sarcoma and osteosarcoma [2,22]. Postoperative chemotherapy also has its bene ts such as its reported improving of the 5-year survival rate [7]. Recently, as biological technology has evolved, targeted therapy becomes possible and has already made some achievements [23,24].…”

“…Recently, the increasing demand for retaining a good quality of life makes amputation no longer an optimal option. With technological development and improved understanding of bone tumor, prosthesis arthroplasty coupled with pre-and postoperational chemotherapies could serve as an alternative limb-salvage method for bone tumor patients and there has already been some clinical progress in this regard [6,7]. There are many types of bone tumor prostheses such as single-axis hinged prosthesis [8], rotating hinged prosthesis [9], condyle constrained prosthesis [10], and a newly revised pivot knee prosthesis developed by Beijing Chunlizhengda Medical Equipment Co., LTD; each prosthesis has its merits and de ciencies.…”

<p>Nudol, a phenanthrene derivative from <em>Dendrobium nobile</em>, induces cell cycle arrest and apoptosis and inhibits migration in osteosarcoma cells</p>

“…Traditional therapeutic approaches for osteosarcoma include local control of the primary lesion by surgery and/or chemotherapy, and treatment of disseminated disease with multi-agent cytotoxic chemotherapy 3. However, the current five-year survival rate for patients with osteosarcoma is only 5%–20%,4 and a significant proportion of osteosarcoma cases has shown strong resistance to the present chemotherapies. Consequently, development of new, more effective, and well-tolerated therapeutics remains a pressing task.…”