The online version of this article (doi:10.1186/1477-7819-10-191) contains supplementary material, which is available to authorized users.
Bicheng Yong, Pingxian Tan contributed equally to this work.
We declare that we have no conflicts of interest.
JNS and JW conceived the study. BCY, PXT, CYZ did the chart review. BCY and YQW followed up the patients and obtained the survival information. GH and BCY performed the statistical analysis and interpreted the results. BCY, XBX and JQY performed the literature review and wrote the manuscript. All authors read and approved the final manuscript.
We sought to determine whether suboptimal chemotherapy compromised the prognosis of osteosarcoma patients.
A total of 132 eligible patients who underwent chemotherapy between 1998 and 2008 were identified in our database. Information regarding patient demographics, clinical characteristics, and survival status were extracted for analysis. Optimal chemotherapy was defined as receipt of ≥80% of the planned dose intensity of prescribed agents within the planned durations.
The use of optimal chemotherapy resulted in an overall survival benefit with P = 0.006. Patients who failed to complete the optimal chemotherapy protocol had a dismal prognosis of 30.8% overall survival over five years, whereas those who completed the optimal chemotherapy had an overall survival rate over five years of 65.3%. Based on multivariate analysis, patients who were treated with a suboptimal protocol had a higher risk of relapse, metastasis and mortality. The hazard ratio (HR) of recurrence or death for the suboptimal chemotherapy group was as high as 2.512 over that of the optimal chemotherapy group (HR = 2.512, 95% confidence interval = 1.242 to 3.729).
Chemotherapy is a significant independent prognostic variable, and suboptimal chemotherapy was found to have a detrimental effect on the outcome of patients with osteosarcoma.
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