Abstract: PURPOSE: To analyze the outcome of neoadjuvant chemotherapy in the treatment of head and neck osteosarcoma. METHODS: A retrospective study of head and neck osteosarcoma patients treated from 2007 to 2015 was conducted. The clinical, radiological, pathological, treatment information and follow-up records were collected. Statistical analysis was performed with SPSS 17.0 software package. RESULTS: One hundred and fifty-seven patients were included, with a 5-year overall survival rate (OS) of 50.96%. Sixty-eight were male, 89 were female. Fifty-one were aged less than 30 years old, 85 were within 31-60 years old, 21 were more than 61 years old. Ninety-one had tumor in the mandible while 66 in the maxilla and skull base. One hundred and forty-one were high-grade osteosarcoma, 8 were low-grade osteosarcoma, 8 were unknown differentiated. Fifty-four had tumor > 4 cm and 103 ≤4 cm in diameter. Seven had positive surgical margin. Sixty-five were treated with surgery alone, 15 had surgery and chemotherapy, 23 had surgery combined with chemoradiotherapy, 54 had surgery and radiotherapy. Univariate analysis showed that distant metastasis were related with maxillary and skull base tumors (P=0.022), high-grade osteosarcoma (P=0.011) and positive margin (P=0.031). Osteosarcoma of the mandible(P=0.032), negative margin (P=0.006) were correlated with overall survival. Surgical margin (P=0.007) was associated with disease free survival. Multivariate analysis showed that tumor region (P=0.034), surgical margin (P=0.006), chemotherapy (P=0.025) and pathological subtype (P=0.012) were correlated with OS. Positive margin (P=0.002) and without adjuvant radiotherapy(P=0.005) were associated with local recurrence. CONCLUSIONS: Negative surgical margin is important for good prognosis. Chemotherapy (neoadjuvant chemotherapy and adjuvant chemotherapy) can improve the OS of patients with head and neck osteosarcoma

Key words: Head and neck, Osteosarcoma, Neoadjuvant chemotherapy, Prognosis