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Cancer Chemotherapy
Regimen for Osteosarcoma Cancer
VML-A
osteosarcoma(108)
_________________________________________________________________
vincristine..... 2.0 mg/sqm (maximum single dose 2.0 mg) IV on
day 1.
methotrexate.... 7,500 mg/sqm IV over 6 h beginning 30 min after
vincristine.
leucovorin...... 15 mg IV every 3 h times 8, then 15 mg orally
every 6 h times 8, beginning 2 h after
methotrexate administration is completed.
adriamycin...... 75 mg/sqm IV every 3 weeks times 6, beginning
with the fifth course of VML.
FREQUENCY....... 24 courses of VML + VML-A, cycled as follows,
are administered:
VML every week times 4, then
VML-A every 3 weeks times 6, then
VML every week times 4, then
VML every 3 weeks times 6, then
VML every week times 4.
reference...
Goorin AM. Perez-Atayde A. Gebhardt M. Andersen
JW. Wilkinson RH. Delorey MJ. Watts H. Link
M. Jaffe N. Frei E 3d. et al. Weekly high-dose
methotrexate and doxorubicin for
osteosarcoma: the Dana-Farber Cancer Institute/the Children's Hospital--study
III. Journal of Clinical Oncology. 5(8):1178-84, 1987 Aug.
abstract...
Weekly high-dose methotrexate with leucovorin rescue and vincristine
(HDMTX) and doxorubicin was administered as adjuvant postoperative
therapy to 46 patients with a diagnosis
of conventional high-grade nonmetastatic osteosarcoma of an extremity
between July 1976 and December 1981. The primary lesions were managed
by wide or radical amputation (26 patients) or by limb-sparing resection
in 20 selected patients. The margins of the resections were retrospectively
classified as marginal in three, wide in 16, and radical in one. The
5-year relapse-free survival (RFS) for all patients is 59% (95% confidence
interval [CI], 43%, 74%) and overall
survival is 78% (95% CI, 65%, 91%). The RFS for patients initially
having a limb resection procedure is 55% (95% CI, 32%, 77%) compared
with 62% (95% CI, 43%, 81%) for those initially having amputations
(P = .52). Using multivariate analysis, the only significant prognostic
variables that predicted RFS of greater than or equal to 3 years,
were the presence of moderate to marked lymphocytic infiltration of
the primary tumor (P less than .002), primary site outside of the
proximal humerus (P less than .005), and the absence of a predominance
of osteoblastic pattern in the primary tumor (P less than .03).
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