High-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (ASCT) as salvage therapy for relapsed osteosarcoma
High-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (ASCT) as salvage therapy for relapsed osteosarcoma
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DOI：
10.1038/sj.bmt.1703023
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发表时间：
2001-05-01
影响因子：
4.8
通讯作者：
Zintl, F
中科院分区：
文献类型：
--
作者：
Sauerbrey, A;Bielack, S;Zintl, F
在这份报告中，我们描述了我们的经验，高剂量化疗（HDC）和自体干细胞移植（ASCT）的15名儿童复发骨肉瘤谁是治疗的合作骨肉瘤研究组的成员。8例患者在第一次复发后接受HDC，6例患者在第二次复发后接受HDC，1例患者在第六次复发后接受HDC。13例患者在完全缓解期接受了HDC和ASCT，2例患者有肉眼可见的肿瘤残留。7例患者在美法仑和依托泊苷的基础上接受了HDC，其中4例患者在此基础上加用卡铂。2例接受卡铂、足叶乙甙、塞替派或环磷酰胺治疗，6例接受双HDC治疗。在所有6例患者中，第一种HDC由塞替派/环磷酰胺组成，第二种方案包括美法仑/依托泊苷（2例患者）、美法仑/依托泊苷/卡铂（2例患者）和美法仑/白消安（2例患者）。15例患者中有3例死于中毒并发症。8名患者进一步复发，2名患者表现出持续性疾病，2名患者目前处于持续完全缓解状态。在8个月的中位随访（MFU）内，无复发生存的概率为0.20 +/- 0.12，在16个月的MFU后，总生存的概率为0.29 +/- 0.12。总之，与传统复发治疗相比，在该患者组中使用HDC和ASCT并未显著改善治疗结局。
In this report, we describe our experience with high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) in 15 children with relapsed osteosarcoma who were treated by members of the Cooperative Osteosarcoma Study Group. Eight patients received HDC after the first relapse, six patients after the second relapse and one after the sixth relapse. Thirteen patients underwent HDC and ASCT in complete remission and two patients had macroscopic tumor residues. Seven patients received HDC based on melphalan and etoposide, Four of these patients were treated with additional carboplatinum. Two patients received carboplatinum, etoposide, and thiotepa or cyclophosphamide, In six patients double HDC was performed. In all six of these, the first HDC consisted of thiotepa/cyclophosphamide, The second regimens included melphalan/etposide (two patients), melphalan/etposide/carboplatinum tone patient), and melphalan/busulfan tone patient). Three of the 15 patients died of toxic complications. Eight patients developed further relapses, two patients showed persistent disease, and two patients are presently in continuous complete remission. The probability of relapse-free survival was 0.20 +/- 0.12 within a median follow-up (MFU) of 8 months and the probability of overall survival was 0.29 +/- 0.12 after a MFU of 16 months. In conclusion, utilization of HDC and ASCT in this patient group did not significantly improve the treatment outcome compared to conventional relapse therapy.