Effects of Arsenic Trioxide on Minor Progressive High-Grade Osteosarcoma of the Extremities Metastatic to the Lung: Results of 39 Patients Treated in a Single Institution

Lu Xie, Wei Guo, Xiaodong Tang, Yi Yang, Jie Xu, Lu Xie, Wei Guo, Xiaodong Tang, Yi Yang, Jie Xu

Abstract

Patients who mildly progressed after first-line chemotherapy were administered arsenic trioxide (ATO) 5-10 mg intravenously daily. Thirty-nine patients were finally enrolled in the study, of whom 19 patients received first-line chemotherapy with ATO infusion while 20 patients did not. Progression-free survival at 4 months was 89.2 and 62.7% (p = 0.043) for the ATO group and the control group, respectively, while the 2-year overall survival was 61 and 16.4% (p = 0.032).

Keywords: Arsenic trioxide; Osteosarcoma, minor progressive; Pulmonary metastasis.

Figures

Fig. 1
Fig. 1
Main diagram manifesting all patients who participated in this trial. PD = Progressive disease.
Fig. 2
Fig. 2
Therapeutic protocol for the research group who received first-line chemotherapy with ATO. Doses administered were: doxorubicin (ADM): 60 mg/m2; cisplatin (CDDP): 100–120 mg/m2; ifosfamide (IFO): 2.4 g/m2/day on days 1–5; ATO: 10 mg (5 mg) on days 1–28; methotrexate (MTX): 8–12 g/m2; leucovorin: 12–15 mg i.m. every 6 h for 12 doses – start 18 h from high-dose methotrexate (HDMTX).
Fig. 3
Fig. 3
Therapeutic protocol for the control group who received first-line chemotherapy alone. Doses administered were: doxorubicin (ADM): 60 mg/m2; cisplatin (CDDP): 100–120 mg/m2; ifosfamide (IFO): 2.4 g/m2/day on days 1–5; methotrexate (MTX): 8–12 g/m2; leucovorin: 12–15 mg i.m. every 6 h for 12 doses – start 18 h from high-dose methotrexate (HDMTX).
Fig. 4
Fig. 4
PFS for the two patient groups.
Fig. 5
Fig. 5
OS for the two patient groups.
Fig. 6
Fig. 6
Therapeutic effect of all patients who participated in the study (n = 39).
Fig. 7
Fig. 7
Chest CT of a patient (No. 10), with CR for more than a year, showed multiple pulmonary mini-nodules disappearing after treatment. a–c One nodule (arrow) located at the middle left lobe which disappeared 1 year and 2 months after therapy. d–f Another nodule (arrow) located at the middle right lobe which disappeared after therapy. g–i Another nodule (arrow) from the same person with CR after therapy.

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