[Preliminary report of combination chemotherapy including Arsenic trioxide for stage III osteosarcoma and Ewing...

To determine the efficacy of Arsenic trioxide combined with other chemo agents in patients with metastatic osteosarcoma and Ewing sarcoma.

From December 2002 to June 2005, 32 patients with metastatic osteosarcoma and Ewing sarcoma were treated with chemotherapy comprised Arsenic trioxide, including 19 male and 13 female, aging from 7 to 32 years. Diagnoses included 27 cases with osteosarcomas and 5 with Ewing sarcomas. Twenty-five and 7 patients had multiple lung and skeletal metastasis respectively. All patients had received 4 to 6 cycles standard chemotherapy and surgical treatments before the metastatic lesions were found. The chemotherapy protocol consisted of Arsenic trioxide, VP-16 and paclitaxel. Twenty-eight patients accepted 2 cycles, and 4 patients accepted 3 cycles chemotherapy.

Five patients (15.6%), whose lung focus disappeared and no new metastases proved, got complete response (CR); Six patients (18.8%) got partial response (PR); In thirteen stable disease (SD) patients (40.6%), the metastatic lesions did not reduce in evidence but completely calcified in 2 patients and partly calcified in 11 patients; Eight patients (25%) whose tumor size was even bigger after the chemotherapy were defined as progress disease (PD). The average follow-up period was 20 months (ranging from 6 months to 3 years). Three patients were eventually died; The disease was progressed in 5 patients, and the tumor growth was controlled in 24 patients.

Arsenic trioxide is a low-toxic and effective remedy for treatment of stage III osteosarcoma and Ewing sarcoma.