The role of chemotherapy and radiotherapy in localized extraskeletal osteosarcoma

被引：59

作者：

Heng, Marilyn ^{[1
]}

Gupta, Abha ^{[2
]}

Chung, Peter W. ^{[3
]}

Healey, John H. ^{[5
]}

Vaynrub, Max ^{[5
]}

Rose, Peter S. ^{[6
]}

Houdek, Matthew T. ^{[6
]}

Lin, Patrick P. ^{[7
]}

Bishop, Andrew J. ^{[8
]}

Hornicek, Francis J. ^{[1
,9
]}

Chen, Yen-Lin ^{[1
]}

Lozano-Calderon, Santiago ^{[1
]}

Holt, Ginger E. ^{[10
]}

Han, Ilkyu ^{[11
]}

Biau, David ^{[12
]}

Niu, Xiaohui ^{[13
]}

Bernthal, Nicholas M. ^{[1
]}

Ferguson, Peter C. ^{[14
,15
]}

Wunder, Jay S. ^{[14
,15
]}

Ueda, Takafumi ^{[16
]}

Kakunaga, Shigeki ^{[16
]}

Kawai, Akira ^{[17
]}

Sugiura, Hideshi ^{[18
]}

Kidani, Teruki ^{[19
]}

Kunisasa, Toshiyuki ^{[20
]}

Ozaki, Toshifumi ^{[20
]}

Ae, Keisuke ^{[21
]}

Nagano, Akihito ^{[22
]}

Ohno, Takatoshi ^{[22
]}

Hiraoka, Koji ^{[23
]}

Yamamoto, Norio ^{[24
]}

Tsuchiya, Hiroyuki ^{[24
]}

Matsumoto, Yoshihiro ^{[25
]}

Yanagawa, Takashi ^{[26
]}

Nakayama, Robart ^{[27
]}

Morioka, Hideo ^{[27
]}

Kubo, Tadahiko ^{[28
]}

Simose, Shoji ^{[28
]}

Yamagami, Yoshiki ^{[29
]}

Yamamoto, Tetsuji ^{[29
]}

Kawasaki, Motohiro ^{[30
]}

Torigoe, Tomoaki ^{[31
]}

Yazawa, Yasuo ^{[31
]}

Akiyama, Toru ^{[32
]}

Gokita, Tabu ^{[33
]}

Manabe, Jun ^{[33
]}

Kaya, Mitsunori ^{[34
]}

Emori, Makoto ^{[34
]}

Nakamura, Tomoki ^{[35
]}

Matsumine, Akihiko ^{[35
]}

机构：

[1] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA 02115 USA

[2] Princess Margaret Canc Ctr, Dept Med Oncol, Toronto, ON, Canada

[3] Univ Toronto, Dept Radiat Oncol, Radiat Med Program, Princess Margaret Canc Ctr, Toronto, ON, Canada

[4] Japanese Musculoskeletal Oncol Grp, Tokyo, Japan

[5] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[6] Mayo Clin, Rochester, MN USA

[7] Univ Texas MD Anderson Canc Ctr, Dept Orthopaed Oncol, Houston, TX 77030 USA

[8] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA

[9] Univ Calif Los Angeles, Dept Orthopaed Surg, Los Angeles, CA USA

[10] Vanderbilt Univ, Med Ctr, Dept Orthopaed Surg & Rehabil, Nashville, TN USA

[11] Seoul Natl Univ Hosp, Dept Orthopaed Surg, Seoul, South Korea

[12] Univ Paris 05, Hop Cochin, AP HP, INSERM,U1153, Paris, France

[13] Peking Univ, Beijing Jishuitan Hosp, Dept Orthopaed Oncol Surg, Beijing, Peoples R China

[14] Univ Toronto, Mt Sinai Hosp, Musculoskeletal Oncol Unit, Toronto, ON, Canada

[15] Princess Margaret Canc Ctr, Dept Surg Oncol, Toronto, ON, Canada

[16] Osaka Natl Hosp, Osaka, Japan

[17] Natl Canc Ctr, Tokyo, Japan

[18] Aichi Canc Ctr Hosp, Nagoya, Aichi, Japan

[19] Ehime Univ, Matsuyama, Ehime, Japan

[20] Okayama Univ, Okayama, Japan

[21] Canc Inst Hosp, Tokyo, Japan

[22] Gifu Univ, Gifu, Japan

[23] Kurume Univ, Kurume, Fukuoka, Japan

[24] Kanazawa Univ Hosp, Kanazawa, Ishikawa, Japan

[25] Kyushu Univ, Fukuoka, Japan

[26] Gunma Univ Hosp, Maebashi, Gunma, Japan

[27] Keio Univ, Tokyo, Japan

[28] Hiroshima Univ, Hiroshima, Japan

[29] Kagawa Univ, Takamatsu, Kagawa, Japan

[30] Kochi Med Sch, Kochi, Japan

[31] Saitama Int Med Ctr, Saitama, Japan

[32] Jichi Med Univ, Saitama Med Ctr, Shimotsuke, Tochigi, Japan

[33] Saitama Canc Ctr, Saitama, Japan

[34] Sapporo Med Univ, Sapporo, Hokkaido, Japan

[35] Mie Univ, Tsu, Mie, Japan

[36] Shikoku Canc Ctr, Matsuyama, Ehime, Japan

[37] Kagoshima Univ, Kagoshima, Japan

[38] Juntendo Univ, Tokyo, Japan

[39] Kobe Univ, Kobe, Hyogo, Japan

[40] Shizuoka Canc Ctr, Nagaizumi, Shizuoka, Japan

[41] Chiba Canc Ctr, Chiba, Japan

[42] Osaka Med Coll, Takatsuki, Osaka, Japan

[43] Osaka City Univ, Osaka, Japan

[44] Osaka Univ, Osaka, Japan

[45] Osaka Med Ctr Canc, Osaka, Japan

[46] Tokyo Univ Hosp, Tokyo, Japan

[47] Tohoku Univ Hosp, Sendai, Miyagi, Japan

[48] Hyogo Med Coll, Nishinomiya, Hyogo, Japan

[49] Hokkaido Canc Ctr, Sapporo, Hokkaido, Japan

[50] Nagoya Univ, Nagoya, Aichi, Japan

来源：

EUROPEAN JOURNAL OF CANCER | 2020年 / 125卷

基金：

日本学术振兴会;

关键词：

Extraskeletal osteosarcoma; Soft-tissue osteosarcoma; Chemotherapy; Radiotherapy; Radiation therapy; GRADE EXTRAOSSEOUS OSTEOSARCOMA; MULTIMODALITY THERAPY LIKE; OSTEOGENIC-SARCOMA; BONE; TESTS; RISK;

D O I：

10.1016/j.ejca.2019.07.029

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods: Retrospective review at 25 international sarcoma centers identified patients >= 18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplane-Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results: 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%-62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26-0.80], p = 0.01). Conclusion: Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS. (C) 2019 Elsevier Ltd. All rights reserved.

引用

页码：130 / 141

页数：12

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