Local control of osteosarcoma primarily is a surgical problem, but histologic response to neoadjuvant therapy is the single most important prognostic factor for long-term survival in nonmetastatic osteosarcoma of the extremity.IA therapy might be able to provide better guidance but this is not proven. Currently, doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue and ifosfamide are considered the most active agents against osteosarcoma.
IA cisplatin is not standard of care. It is not NCCN recommended. Instead, NCCN on Bone-C,1 recommends for fits-line: docetaxel/gemcitabine, cisplatin and doxorubicine, MAP, doxirubine/cisplatin/ifosfamide/high-dose methotrexate, ifosfamide/cisplatin/epirubicin.