Addition of pamidronate to chemotherapy for the treatment of osteosarcoma

Cancer. 2011 Apr 15;117(8):1736-44. doi: 10.1002/cncr.25744. Epub 2010 Nov 8.


Background: This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma.

Methods: The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated.

Results: For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances.

Conclusions: Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Cisplatin / administration & dosage
  • Diphosphonates / administration & dosage*
  • Diphosphonates / adverse effects
  • Doxorubicin / administration & dosage
  • Drug Administration Schedule
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Methotrexate / administration & dosage
  • Osteosarcoma / drug therapy*
  • Pamidronate


  • Diphosphonates
  • Doxorubicin
  • Pamidronate
  • Cisplatin
  • Methotrexate