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Published on: March 18, 2014
Addition of pamidronate to chemotherapy for the treatment of osteosarcoma
Paul A Meyers1, John H Healey, Alexander J Chou
1Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. meyersp@mskcc.org
Background:
This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma.
Methods:
The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated.
Results:
For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances.
Conclusions:
Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction.
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