Long-term evaluation of surgery followed by adjuvant adriamycin in osteogenic sarcoma

From 1974 to 1978 29 consecutive patients with operable osteogenic sarcoma entered 2 successive clinical trials of adjuvant chemotherapy with adriamycin (ADM) alone. Following radical surgery the first group of 14 patients received ADM 75 mg/sqm q 4 weeks for a total of 8 doses, the second group received ADM 30 mg/sqm daily for 3 days every 4 weeks for a total of 6 cycles. All patients belonging to the first group underwent amputation or exarticulation, while in 4 of 15 of the second group a limb-sparing surgery was performed. Lung tomograms as well as bone scans were not mandatory in the initial work-up. Follow-up ranged from 7 to more than 11 years. Thirteen patients (45%) remain continuously relapse-free survivors: 4 of 14 (28.5%) in the first group and 9 of 15 (60%) in the second group. This difference is not statistically significant. The longest free interval in the 16 patients relapsed was 32 months. Severe toxicity from ADM was observed in only 1 patient and consisted of reversible cardiomyopathy. ADM alone as postoperative adjuvant chemotherapy for osteogenic sarcoma achieved results comparable to those obtained by other contemporary more complex regimens of combination chemotherapy.