Efficacy of Neoadjuvant Chemotherapy plus Limb-Sparing Surgery for Osteosarcoma and Its Impact on Long-Term Quality of Life.

Abstract

Purpose To assess the efficacy of neoadjuvant chemotherapy plus limb-sparing surgery for osteosarcoma and its impact on long-term quality of life. Methods Between August 2016 and December 2018, 90 patients with osteosarcoma treated in Nanchong Central Hospital were recruited and divided at a ratio of 1 : 1 to receive limb-sparing surgery (control group) or limb-sparing surgery plus neoadjuvant chemotherapy (study group) by random number table methods. The clinical endpoints were clinical efficacy and long-term quality of life. Results Limb-sparing surgery plus neoadjuvant chemotherapy was associated with a significantly higher efficacy versus limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy resulted in a significantly higher Enneking score and a higher good function rating of patients versus limb-sparing surgery. The two groups showed a high but similar 1-year survival rate. Patients given limb-sparing surgery plus neoadjuvant chemotherapy showed significantly higher 2-year and 3-year survival and a longer mean survival versus those receiving limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy resulted in significantly higher scores of role emotional, mental health, physical function, and social function and a lower bodily pain score than limb-sparing surgery alone. Limb-sparing surgery plus neoadjuvant chemotherapy was associated with significantly lower fatigue, nausea and vomiting, dyspnea, constipation, and diarrhea scores and a significantly higher health status score versus monotherapy of limb-sparing surgery. Conclusion Neoadjuvant chemotherapy plus limb-sparing surgery improves the postoperative limb function and long-term quality of life of patients with osteosarcoma, which shows great potential for clinical promotion.