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By Amy Norton
SAN FRANCISCO, Mar 02 (Reuters Health) - Hitting the bone cancer osteosarcoma with a second wave of chemotherapy after surgery may not boost the odds of survival, and instead may increase patients' risk of dying from treatment complications, researchers reported on Thursday.
Osteosarcoma is the most common cancer arising in the bones, and it often strikes children and young adults. While surgery to remove the tumors is the cornerstone of treatment, chemotherapy is often used to help wipe out cancer cells.
In a study of 54 patients with osteosarcoma, researchers at Duke University in Durham, North Carolina, found that those who were treated with chemotherapy both before and after surgery had poorer survival compared with those who received no postsurgery chemo. Following patients for about 5 years on average, Dr. Keith R. Berend and his colleagues found that 68% of patients who received only the initial chemotherapy plus surgery survived. That compares with a survival rate of 46% among those who also received postsurgery, or adjuvant, chemotherapy.
In addition, five patients who received adjuvant chemotherapy died from chemotherapy-related complications, mainly secondary cancer. None of the other patients died from conditions associated with chemotherapy, Berend reported here at the annual meeting of the American Academy of Orthopedic Surgeons.
However, Berend stressed, these findings are preliminary and should lay the groundwork for larger studies--not change patients' treatment.
"This questions the routine use of adjuvant chemotherapy," Berend said. But, he added, the study also suffers from the "pitfalls" of a being a review of patient cases, rather than a forward-looking study that follows patients randomly assigned to receive a treatment. It is possible that some patients received additional treatment based on the characteristics of their illness.
Another surgeon at the meeting was more critical. Dr. John Healey of the Hospital for Special Surgery in New York City said it would be "dangerous" to give the Duke findings much credence. The difference in survival between the groups, Healey said, was probably due to factors such as the chemotherapy drugs that were used. He cautioned against indicting the use of adjuvant chemotherapy altogether.
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