{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:50:49Z","timestamp":1790232649659,"version":"4.1.0"},"reference-count":52,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2002,4,15]]},"abstract":"<jats:p> PURPOSE: To study the feasibility and activity of two courses of high-dose chemotherapy (HDCT) in patients with osteosarcoma in metastatic relapse. <\/jats:p><jats:p> PATIENTS AND METHODS: Patients with high-grade osteosarcoma in metastatic relapse (multiple metastases or solitary metastasis at intervals of less than 30 months) were eligible for study. High-dose chemotherapy consisted of carboplatin and etoposide followed by stem-cell rescue. A second course was planned 4 to 6 weeks after the first. Surgery was performed before or after HDCT. <\/jats:p><jats:p> RESULTS: Thirty-two patients were enrolled onto the study. At the end of the treatment, 25 patients were in complete remission (CR), six were alive with disease progression, and one died of toxicity. At present, 14 patients are alive with a median survival time of 23 months from study entry: four are in first CR, three are in second CR, and one is in fourth CR. Six patients are alive with disease. Eighteen patients (56%) died: 17 of disease and one of toxicity. Transplantation-related mortality was 3.1%. The relapse or progression disease rate was 84.4%. The 3-year overall survival rate is 20% and the 3-year disease-free survival rate is 12%. <\/jats:p><jats:p> CONCLUSION: HDCT combined with surgery is feasible and can induce CR in a large portion of patients. Two points, however, need to be considered: only patients who are chemosensitive to induction treatment can obtain CR after HDCT, and the length of remission is short, because most patients relapse. Thus novel strategies are needed to maintain the remission status or to treat patients who do not respond to induction treatment. <\/jats:p>","DOI":"10.1200\/jco.2002.08.081","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T13:13:48Z","timestamp":1027775628000},"page":"2150-2156","source":"Crossref","is-referenced-by-count":115,"title":["High-Dose Chemotherapy in the Treatment of Relapsed Osteosarcoma: An Italian Sarcoma Group Study"],"prefix":"10.1200","volume":"20","author":[{"given":"F.","family":"Fagioli","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Aglietta","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tienghi","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ferrari","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Brach del Prever","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Vassallo","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Palmero","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Biasin","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bacci","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Picci","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Madon","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, University of Turin; Department of Clinical Oncology, Ordine Mauriziano\u2013Institute for Cancer Research and Treatment, Turin; Department of Oncology, Ospedale S. Maria delle Croci, Ravenna; and Department of Chemotherapy, Department of Musculoskeletal Tumors, Istituto Ortopedico Rizzoli, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900601)65:11<2539::AID-CNCR2820651125>3.0.CO;2-M"},{"key":"R2-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19931201)72:11<3227::AID-CNCR2820721116>3.0.CO;2-C"},{"key":"R3-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.7.2452"},{"key":"R4-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.10.1766"},{"key":"R5-107033","doi-asserted-by":"publisher","DOI":"10.1080\/1120009X.1992.11739163"},{"key":"R6-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.24.4028"},{"key":"R7-107033","unstructured":"Saeter  G:   Treatment of osteosarcoma with high-dose methotrexate-containing neoadjuvant chemotherapy:  Scandinavian Sarcoma Group data.   Med Pediatr Oncol 27:  263,1996  (abstr)"},{"key":"R8-107033","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.1999.11744828"},{"key":"R9-107033","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/83.20.1460"},{"key":"R10-107033","doi-asserted-by":"publisher","DOI":"10.1080\/1120009X.1990.11738996"},{"key":"R11-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.2.658"},{"key":"R12-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.12.2699"},{"key":"R13-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950301)75:5<1084::AID-CNCR2820750506>3.0.CO;2-F"},{"key":"R14-107033","unstructured":"Saeter  G:   Treatment strategies and outcome in metastatic (relapsed) osteogenic sarcoma:  The Scandinavian Sarcoma Group (SSG) Experience.   Med Pediatr Oncol 27:  264,1996  (abstr)"},{"key":"R15-107033","unstructured":"Bacci  G,   Briccoli  A,   Picci  P,  et al:   Osteosarcoma of the extremities metastatic at presentation:  Results obtained with primary chemotherapy followed by simultaneous resection of the primary and metastatic lesions.   Cancer J 3:  213,1990-218,"},{"key":"R16-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19921201)70:11<2722::AID-CNCR2820701125>3.0.CO;2-S"},{"key":"R17-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.3.449"},{"key":"R18-107033","unstructured":"Miniero  R,   Brach del Prever  A,   Vassallo  E,  et al:   Feasibility of high-dose chemotherapy and autologous peripheral blood stem cell transplantation in children with high grade osteosarcoma.  Bone Marrow Transplant 22:  S37,1998-S40,     (suppl 5)"},{"key":"R19-107033","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702792"},{"key":"R20-107033","doi-asserted-by":"publisher","DOI":"10.1080\/1120009X.1993.11739222"},{"key":"R21-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.7.1443"},{"key":"R22-107033","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(83)80551-4"},{"key":"R23-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19870501)59:9<1577::AID-CNCR2820590908>3.0.CO;2-P"},{"key":"R24-107033","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200003000-00007"},{"key":"R25-107033","doi-asserted-by":"publisher","DOI":"10.1007\/BF00689204"},{"key":"R26-107033","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(97)00102-0"},{"key":"R27-107033","unstructured":"Santana  VM,   Schell  MJ,   Williams  R,  et al:   Escalating sequential high dose carboplatin and etoposide with autologous marrow support in children with relapsed solid tumors.  Bone marrow Transplant 10:  457,1992-462,"},{"key":"R28-107033","unstructured":"Meyer  WH,   Pratt  CB,   Rao  BN,  et al:   Curative therapy for osteosarcoma without cisplatin preliminary experience with SJCRH OS-91.  Med Pediatr Oncol 27:  226,1996  (abstr)"},{"key":"R29-107033","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199908)33:2<71::AID-MPO2>3.0.CO;2-T"},{"key":"R30-107033","unstructured":"Robson  H,   Meyer  S,   Shalet  SM,  et al:   Comparative evaluation of cisplatin and carboplatin sensitivity in osteosarcoma cell lines.  Med Pediatr Oncol 33:  167,1999  (abstr)"},{"key":"R31-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.1.171"},{"key":"R32-107033","doi-asserted-by":"crossref","unstructured":"Bearman  SI,   Appelbaum  FR,   Buckner  CD,  et al:   Regimen related toxicity in patients undergoing bone marrow transplantation.  J Clin Oncol 6:  1562,1998-1568,","DOI":"10.1200\/JCO.1988.6.10.1562"},{"key":"R33-107033","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452"},{"key":"R34-107033","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(82)80106-1"},{"key":"R35-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19870115)59:2<374::AID-CNCR2820590235>3.0.CO;2-6"},{"key":"R36-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890615)63:12<2546::AID-CNCR2820631232>3.0.CO;2-X"},{"key":"R37-107033","doi-asserted-by":"crossref","unstructured":"Snyder  CL,   Saltzman  DA,   Ferrel  KL,  et al:   A new approach to the resection of pulmonary osteosarcoma metastases:  Results of aggressive metastasectomy.   Clin Orthop 270:  247,1991-253,","DOI":"10.1097\/00003086-199109000-00032"},{"key":"R38-107033","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1992.01420090073010"},{"key":"R39-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.9.1849"},{"key":"R40-107033","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(81)80848-2"},{"key":"R41-107033","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1984.2.5.425"},{"key":"R42-107033","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19911101)68:9<1899::AID-CNCR2820680909>3.0.CO;2-X"},{"key":"R43-107033","unstructured":"Pratt  CB,   Epelman  S,   Jaffe  N:   Bleomycin, cyclophosphamide and dactinomycin in metastatic osteosarcoma:  Lack of tumor regression in previously treated patients.   Cancer Treat Rep 71:  421,1987-423,"},{"key":"R45-107033","unstructured":"Morgan  E,   Baum  E,   Bleyer  WA,  et al:   Treatment of patients with metastatic osteogenic sarcoma:  A report from the Children\u2019s Cancer Study Group.   Cancer Treat Rep 68:  661,1984-664,"},{"key":"R46-107033","unstructured":"Chawla  SP,   Rosen  G,   Lowenbraun  S,  et al:   Role of high dose ifosfamide (HDI) in recurrent osteosarcoma.  Proc Am Soc Clin Oncol 9:  310,1990  (abstr)"},{"key":"R47-107033","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6690187"},{"key":"R48-107033","unstructured":"Valteau-Couanet  D,   Kalifa  C,   Benhamou  E,  et al:   Phase II study of high dose thiotepa (HDT) and hematopoietic stem cell transplantation (SCT) support in children with metastatic osteosarcoma.  Med Pediatr Oncol 27:  239,1996  (abstr)"},{"key":"R49-107033","unstructured":"Colombat  PH,   Biron  P,   Coze  C,  et al:   Failure of high-dose alkylating agents in osteosarcoma.  Bone Marrow Transplant 14:  665,1994  (abstr)"},{"key":"R50-107033","doi-asserted-by":"crossref","unstructured":"Motzer  RJ,   Mazumdar  M,   Gulati  SC,  et al:   Phase II trial of high dose carboplatin and etoposide with autologous bone marrow transplantation in first line therapy for patients with poor risk germ cell tumors.  J Natl Cancer Inst 8:  1828,1993-1835,","DOI":"10.1093\/jnci\/85.22.1828"},{"key":"R51-107033","doi-asserted-by":"publisher","DOI":"10.1016\/0959-8049(95)00018-E"},{"key":"R52-107033","unstructured":"Broun  ER,   Nichols  CR,   Mandanas  R,  et al:   Dose escalation of high dose carboplatin and etoposide with autologous bone marrow support in patients with recurrent and refractory germ cell tumors.  Bone Marrow Transplant 16:  353,1995-358,"},{"key":"R53-107033","unstructured":"Asada  N,   Tsuchiya  H,   Ueda  Y,  et al:   Establishment and characterization of an acquired cisplatin-resistant subline in a human osteosarcoma cell line.  Anticancer Res 18:  1765,1998-1768,"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2002.08.081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T21:57:55Z","timestamp":1653515875000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2002.08.081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,4,15]]},"references-count":52,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2002,4,15]]}},"alternative-id":["10.1200\/JCO.2002.08.081"],"URL":"https:\/\/doi.org\/10.1200\/jco.2002.08.081","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,4,15]]}}}