Continuous-infusion Ifosfamide and Doxorubicin Combination as Second-Line Chemotherapy for Recurrent or Refractory Osteosarcoma Patients in China: a Retrospective Study

Objective: The aim of this retrospective study was to evaluate the feasibility and efficacy of response tocontinuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for patients withrecurrent or refractory osteosarcoma. Materials and
Methods: Eighteen recurrent or refractory osteosarcomapatients who were treated with continuous-infusion ifosfamide and doxorubicin combination between May 1999and April 2011 were included in the analysis. Ifosfamide at 12g/m2 was administered by intravenous continuousinfusion over 3 days, and doxorubicin 60mg/m2 was administered as an intravenous bolus injection on day 1. Thecombination therapy was repeated every 3 weeks. Treatment was continued until evidence of disease progressionor unacceptable toxicity.
Results: The patients (ages 7-53 years) received a total of 42 cycles of chemotherapy(median: 2 courses; range: 2-5 courses). The overall response rate was 0% and the disease control rate was22.3%, with four patients having stable disease. The median time to progression and overall survival time were2 months (range: 2-5 months) and 9 months (range: 3-29 months), respectively. Major severe toxicities wereleucopenia 7 (38.9%), nausea and vomiting 3 (16.7%) and alopecia 9 (50%). There were no treatment-relateddeaths.
Conclusions: In our experience, continuous-infusion ifosfamide and doxorubicin combination therapyat this dosage and schedule was found to be well tolerated and moderate effective, which could be consideredas salvage therapy for patients with recurrent or refractory osteosarcoma. Further assessment is necessary toconfirm the safety and efficacy of this treatment.