Clinical exploration and study of cisplatin chronochemotherapy for osteosarcoma

CHEN Qian; LIN Lin; CUI Hao-cheng; XU Ming; YU Xiu-chun

doi:10.3969/j.issn.2095-252X.2025.05.002

Abstract：Objective To explore the clinical application value and adverse reaction control of cisplatin infusion in osteosarcoma patients from 16pm to 20pm.Methods This study retrospectively analyzed 28 patients who received preoperative 2 courses and postoperative 6 courses of DIA(cisplatin+adriamycin+ifosfamide)chemotherapy in our department from June 2021 to June 2024.Patients were divided into conventional chemotherapy group and chronochemotherapy group,14 cases in each group.We compared the differences in gastrointestinal reactions such as nausea and vomiting,changes in liver and kidney indexes and myelosuppression between the two groups.Results In acute nausea and vomiting,the complete control rate was 35.71%in the conventional chemotherapy group and 50.00%in the chronochemotherapy group,and there was no statistical significance between them(P>0.05).For delayed malignant vomiting,the complete control rate of chronochemotherapy group was 42.86%on the 2nd day,57.14%on the 3rd day and 71.43%on the 4th day,while the complete control rate of conventional chemotherapy group was 21.43%on the 2nd day and 3rd day and 28.57%on the 4th day.The complete control rate of chronochemotherapy group was significantly better than that of conventional chemotherapy group,and the differences were statistically significant(P<0.05).In terms of liver and kidney indexes(creatinine,urea nitrogen,aminotransferase),there was no statistical difference between the chronochemotherapy group and the conventional chemotherapy group before and after treatment(P>0.05).In terms of bone marrow suppression,the suppression degree of white blood cell count after treatment in the chronochemotherapy group(6.39±3.74)was significantly lower than that in the conventional chemotherapy group(4.04±1.69),and the differences were statistically significant(P<0.05).Other indicators including platelet and red blood cell counts were not statistically significant before and after treatment(P>0.05).Conclusions Cisplatin chronotherapy can effectively alleviate the toxic side effects of chemotherapy and improve the quality of life of patients,which is a new attempt and exploration of chemotherapy for osteosarcoma.