Outpatient chemotherapy for patients with unresectable or metastatic bone sarcomas

Abstract

Background: Outpatient chemotherapy (OC) is one of the treatment options for patients with unresectable or metastatic bone sarcomas, but data regarding the clinical experience with it are few. Method(s): We reviewed consecutive 18 patients with unresectable or metastatic bone sarcomas who were treated in the outpatient chemotherapy unit of Nagoya University Hospital from November 2006 to January 2018. Period from first visit to OC, type, number, and course of regimens, and survival after OC using Kaplan-Meier method were analyzed. There were 12 males and 6 females with a median age of 59 (range 13- 83) years. Histological subtypes were 13 osteosarcomas, 2 MFHs, and 3 others, and all patients except one had metastasis. The median follow-up period after OC was 10.7 (1.2-135.3) months. Result(s): Median period from first visit to OC was 23.7 months. OC was performed as first line in 1, second line in 9, and third line in 8. Median regimens and courses of OC were 1(1-4) and 4.5 (1-30), respectively. OC regimens included CBDCA/ETP (median 9 (3-17) courses) in 11, GEM/DTX (median 2 (1-4) courses) in 7, THP (median 2.5 (1- 18) courses) in 6, and DXR (median 1 (1-2) courses) in 3. Additional treatments were radiation in 7, surgery in 2, and carbon ion radiotherapy in 1. Median survival after OC was 19.8 months in 15 patients without radical treatments. Three patients were treated with surgery or carbon ion radiotherapy, and 2 of them survived 9 years or longer. Conclusion(s): Metastatic bone sarcoma patients are known to have poor survival. OC is a desirable treatment for them because daily life can be maintained, but approved drugs are few in Japan. In our study, survival after OC was acceptable even for patients without radical treatments, and the regimen of CBDCA/ETP was usable for a long time. OC may thus be a good treatment option for advanced bone sarcoma patients.