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Review
. 2018 May 22:12:54-60.
doi: 10.1016/j.jbo.2018.04.001. eCollection 2018 Sep.

Does intensified chemotherapy increase survival outcomes of osteosarcoma patients? A meta-analysis

Ya Zhang  1 , Zewei He  1 , Yanping Duan  2 , Cao Wang  1 , Santoshi Kamar  2 , Xiaoqian Shi  3 , Jifei Yang  1 , Jingqing Yang  1 , Na Zhao  1 , Lei Han  4 , Yihao Yang  1 , Zuozhang Yang  1
Affiliations
Review

Does intensified chemotherapy increase survival outcomes of osteosarcoma patients? A meta-analysis

Ya Zhang et al. J Bone Oncol. .

Abstract

Study design: Meta-analysis.

Background: Although some new insights have been offered for clinical and scientific relevance, minor progress has been made in osteosarcoma treatment after a dramatic survival improvement in the late 1980s with the addition of chemotherapy to surgery. Intensified chemotherapy strategies have been suggested to increase the survival rate of patients with osteosarcoma. We performed this study to access whether intensified chemotherapy strategiesincreased survival outcomes of osteosarcoma patients compared with conventional chemotherapy strategies.

Methods: MEDLINE/PubMed, EMBASE, BIOSIS Previews, and Cochrane Library were searched from database set up to October2016. Randomized controlled trials (RCTs) and comparative clinical trials (CCTs) on intensified versus conventional chemotherapy strategies for osteosarcoma patients met the inclusion criteria, and the methodological quality standard were retrieved and reviewed. Data on participant characteristics, interventions, follow-up period, and outcomes were extracted from the included studies and analyzed by Review Manager 5.3.

Results: 12 studies (8 RCTs and 4CCT) involving 4112 patients were selected. There were no significant differences between intensified and conventional chemotherapy strategies group in 3-year event-free survival (OR, 1.01; 95% CI, [0.74-1.37]; P = 0.97), 5-year event-free survival (OR, 1.00; 95% CI, [0.86-1.17]; P = 0.97), and 5-year overall survival (OR, 1.04; 95% CI, [0.87-1.26]; P = 0.64), and good histologic response to preoperative chemotherapy (OR, 1.12; 95% CI, [0.78-1.60]; P = 0.55). Pooled analysis of local recurrence rate showed that local recurrence rate was significantly decreased in the intensified group compared with that in the conventional group (OR, 0.60; 95% CI, [0.42-0.85]; P = 0.004).

Conclusions: Intensified chemotherapy might not be a preferred treatment for all of the osteosarcoma patients.

Keywords: Chemotherapy; High dosage; Meta-analysis; Osteosarcoma.

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Figures

Fig 1
Fig. 1
The flow chart of screening included studies.
Fig 2
Fig. 2
Pooled analysis of 3-year event-free survival rate between intensified and conventional chemotherapy strategies.
Fig 3
Fig. 3
Pooled analysis of 5-year event-free survival rate between intensified and conventional chemotherapy strategies.
Fig 4
Fig. 4
Pooled analysis of 5-year overall survival rates between intensified and conventional chemotherapy strategies.
Fig 5
Fig. 5
Pooled analysis of local recurrence rate between intensified and conventional chemotherapy strategies.
Fig 6
Fig. 6
Pooled analysis of the rate of good histologic response to preoperative chemotherapy between intensified and conventional chemotherapy strategies.
See this image and copyright information in PMC

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