Abstract
BackgroundWe sought to determine whether suboptimal chemotherapy compromised the prognosis of osteosarcoma patients.MethodsA total of 132 eligible patients who underwent chemotherapy between 1998 and 2008 were identified in our database. Information regarding patient demographics, clinical characteristics, and survival status were extracted for analysis. Optimal chemotherapy was defined as receipt of ≥80% of the planned dose intensity of prescribed agents within the planned durations.ResultsThe use of optimal chemotherapy resulted in an overall survival benefit with P = 0.006. Patients who failed to complete the optimal chemotherapy protocol had a dismal prognosis of 30.8% overall survival over five years, whereas those who completed the optimal chemotherapy had an overall survival rate over five years of 65.3%. Based on multivariate analysis, patients who were treated with a suboptimal protocol had a higher risk of relapse, metastasis and mortality. The hazard ratio (HR) of recurrence or death for the suboptimal chemotherapy group was as high as 2.512 over that of the optimal chemotherapy group (HR = 2.512, 95% confidence interval = 1.242 to 3.729).ConclusionsChemotherapy is a significant independent prognostic variable, and suboptimal chemotherapy was found to have a detrimental effect on the outcome of patients with osteosarcoma.
Highlights
We sought to determine whether suboptimal chemotherapy compromised the prognosis of osteosarcoma patients
We found that suboptimal chemotherapy is an unfavorable prognostic factor in the overall survival (OS), event free survival (EFS), relapse free survival and metastasis free survival of osteosarcoma patients
Patient eligibility We retrospectively reviewed the medical charts of 410 osteosarcoma patients who were treated at our hospital between 1998 and 2008
Summary
We sought to determine whether suboptimal chemotherapy compromised the prognosis of osteosarcoma patients. The five-year overall survival (OS) rate of osteosarcoma patients of all ages has been reported to range from 53% to 58% in the United States and Europe [2]. An approximately 70% long-term event-free survival rate for osteosarcoma patients can currently be achieved by using the standard three-drug chemotherapy protocol that includes cisplatin, doxorubicin and high-dose methotrexate [3]. We found that suboptimal chemotherapy is an unfavorable prognostic factor in the overall survival (OS), event free survival (EFS), relapse free survival and metastasis free survival of osteosarcoma patients. Inadequate finances, poor patient-doctor relationship and psychological and behavioral compromise may contribute to suboptimal chemotherapy
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