High-dose methotrexate with citrovorum factor in osteogenic sarcoma--progress report II.

Area of Science:

• Oncology
• Medical Chemotherapy
• Skeletal System Neoplasms

Background:

• Osteogenic sarcoma is a primary bone cancer with a high risk of pulmonary metastasis.
• Effective adjuvant and neoadjuvant chemotherapy regimens are crucial for improving patient survival.

Purpose of the Study:

• To evaluate the efficacy of a chemotherapy regimen comprising vincristine (VCR), high-dose methotrexate (MTX), and citrovorum factor (CF) in patients with osteogenic sarcoma.
• To assess the impact of adding adriamycin to the VCR, MTX, and CF regimen.
• To investigate the role of this chemotherapy in managing pulmonary metastases and recurrent disease.

Main Methods:

• Administration of VCR, high-dose MTX, and CF to 12 patients with localized osteogenic sarcoma.
• Use of an adjuvant program including adriamycin (VCR, MTX, CF, adriamycin) in 20 patients.
• Weekly administration of VCR, MTX, and CF to 8 patients with pulmonary metastases or unresected primary lesions.
• Combination of VCR, MTX, CF, and adriamycin with radiation therapy in 4 patients with relapsed disease.

Main Results:

• 58% of patients on VCR, MTX, CF achieved long-term freedom from pulmonary metastases.
• Adding adriamycin to the regimen resulted in 80% of patients being free of pulmonary metastases.
• Surgical resection of pulmonary metastases rendered 5 patients disease-free.
• Weekly VCR, MTX, CF showed significant response rates in patients with metastatic or unresected disease.
• Combination therapy with radiation prevented recurrence in relapsed patients.

Conclusions:

• The VCR, MTX, and CF chemotherapy regimen has a significant positive impact on the management of osteogenic sarcoma.
• The addition of adriamycin enhances the effectiveness of the chemotherapy in preventing pulmonary metastases.
• This chemotherapy approach offers viable treatment options for metastatic and recurrent osteogenic sarcoma.