Introduction:

Long term survival rates in osteosarcoma had improved because of neoadjuvant chemotherapy and multimodal therapy. Dose intensity is a factor than can determine outcome in cancer patients.

Objective:

Evaluate adherence to international osteosarcoma treatment protocols and dose intensity in a pediatric population.

Methods:

We analyzed 34 medical records of pediatric patients with osteosarcoma between the year 2009 and 2014. The relative dose intensity (RDI) was estimated by dividing each drug dose / the time (days) between day 1 of chemotherapy and the surgery. After that we compared it with the planned dose intensity.

Results:

Thirty-two patients were included, 13 of them were treated with cisplatin (CDDP)/adriamycin (ADR)/metotrexate and 19 with CDDP/ADR. The RDI average was 0.65 ± 0.21% and the median of time between day 1 of chemotherapy and surgery was 19.25 ± 8.54 weeks. Local control surgery was rejected by 23.5% of patients. Local control surgery was practiced in 23 patients, of which 34.7% reported more than 90% of necrosis.

Conclusions:

Dose intensity is not suitable in this group of patients; which is reported around 85% in international treatment protocols. About surgery, in our patients, it was not practiced on recommended time. Some identified factors in our population that avoid the treatment adherence were: reject to radical surgery, economical issues and overcrowded healthy system.