Pirarubicin versus doxorubicin in neoadjuvant/adjuvant chemotherapy for stage IIB limb high-grade osteosarcoma: does the analog matter?

Med Oncol. 2015 Jan;32(1):307. doi: 10.1007/s12032-014-0307-y. Epub 2014 Nov 29.

Abstract

Pirarubicin (THP), a novel anthracycline derivative of doxorubicin (ADM), is effective in treating patients with advanced, relapsed or recurrent high-grade osteosarcoma. But its role in neoadjuvant/adjuvant chemotherapy of osteosarcoma is still not defined. We conducted a retrospective evaluation of THP-containing chemotherapy for osteosarcoma in comparison with ADM-containing chemotherapy to determine differences in efficacy and toxicities between THP- and ADM-containing regimens. From January 2008 to May 2011, 112 stage IIB limb high-grade osteosarcoma patients were treated in our institute. Fifty-four patients received a median 6 cycles of neoadjuvant/adjuvant chemotherapy consisted of THP (pirarubicin), DDP (cisplatin), IFO (ifosfamide) and MTX (methotrexate), while 58 patients received a median 6 cycles of neoadjuvant/adjuvant chemotherapy consisted of ADM (doxorubicin), DDP (cisplatin), IFO (ifosfamide) and MTX (methotrexate). Efficacy and toxicity of the 2 anthracyclines given as combination chemotherapy were assessed in these patients. The limb salvage rate, histologic response rate, 2-year recurrence rate, 2-year metastasis rate, 2-year disease-free survival rate, 2-year overall survival rate, median disease-free survival time (DFS) and median overall survival time (OS) in THP-containing group were similar to that in ADM-containing group. Toxicities were well balanced in two groups. No death related to chemotherapy was observed. Left ventricular ejection fraction was unchanged 1 and 2 years after chemotherapy in two groups. Efficacy and toxicity of THP-containing combination are similar to those of ADM-containing combination in neoadjuvant/adjuvant chemotherapy for stage IIB limb high-grade osteosarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / mortality
  • Chemotherapy, Adjuvant / methods
  • Child
  • Cisplatin / therapeutic use
  • Disease-Free Survival
  • Doxorubicin / analogs & derivatives*
  • Doxorubicin / therapeutic use*
  • Extremities
  • Female
  • Humans
  • Ifosfamide / therapeutic use
  • Kaplan-Meier Estimate
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Neoplasm Grading
  • Neoplasm Staging
  • Osteosarcoma / drug therapy*
  • Osteosarcoma / mortality
  • Retrospective Studies
  • Young Adult

Substances

  • Doxorubicin
  • pirarubicin
  • Cisplatin
  • Ifosfamide
  • Methotrexate