Evaluation of clinical process in osteosarcoma patients treated with chemotherapy including cisplatin, adriamycin, ifosfamide, and etoposide and determination of the treatment sequels in a long-term 11-year follow-up

Aim: The aim of this study was to evaluate the effect of adding etoposide and ifosfamide chemotherapy drugs to treatment regimen of patients affected with osteosarcoma and to determine the clinical process and response to treatment during a follow-up period of 11 years. Materials and Methods: Forty patients with osteosarcoma participated in this study from July 2005 to 2016. Treatments were started based on the following schema and after initial examinations including biochemical profile, checking for lung metastasis by simple radiography, chest computed tomography scan, and bones scan. The initial chemotherapy which consisted of four cycles of cisplatin and adriamycin alternative with ifosfamide and etoposide was provided. Afterward, resection of the primary tumor and also the metastatic lesions was performed in patients with lung metastasis in case they had radiological evidence of response to the treatment. Results: The mean of follow-up duration in this study was 50 months. Thirty-four patients did not have metastasis and six were metastatic. Of 34 patients, 18 had relapse and 16 patients never had relapse. Five patients experienced only local relapse, nine had only systemic relapse, and two patients had simultaneous systemic and local relapses. Thirteen patients had died. The mean of overall survival in patients was 81 months. The mean of survival in patients with and without primary metastasis was 30 and 90 months, respectively. Conclusion: Favorable response to the treatment was obtained with an appropriate multiple disciplinary works in the osteosarcomas of extremities, and there were no considerable side effects and sequels in the long-term follow-up of these treatments.