多项针对骨肉瘤的多药治疗方案的研究显示出不同的疗效，但仍存在争议。与此同时，几十年来化疗方案基本保持不变。本研究旨在通过荟萃分析来确定甲氨蝶呤、多柔比星和顺铂方案用于骨肉瘤患者化疗的结果和安全性。我们从多个数据库中询问了将 MAP 方案与其他方案作为骨肉瘤化疗进行比较的试验，包括PubMed、Science Direct 和灰色文献（Google Scholar）截止至 2022 年 12 月。随后分析了分析结果，包括无事件生存期 (EFS)、总生存期 (OS)、肿瘤坏死 (TN) 率和不良事件 (AE)在固定或随机效应模型中使用 RevMan 5.4 软件。我们的荟萃分析包含 8 篇前瞻性文章，评估了累计 2920 名 OS 患者。分析结果显示5年EFS（OR=0.99，95% CI=0.77-1.27，[P=0.91]）和新辅助化疗反应（TN）（OR=0.76，95% CI=0.49-1.17）无显着差异。 , [P = 0.22]) MAP 组和对照组之间的差异。此外，5 年 OS 分析显示对照组存在显着相关性（OR=0.82，95% CI=0.68-0.99，[P = 0.04]）。然而，与 MAP 组相比，对照组与统计学上有意义的 AE 相关，特别是血小板减少症（OR=0.46，95% CI=0.23-0.90，[P=0.02]）和发热（OR=0.34，95% CI= 0.26-0.46，[P < 0.00001]）。本荟萃分析表明，考虑到 MAP 方案中 AE 发生率较低，尽管与其他方案相比没有显着结果，但 MAP 方案在治疗骨肉瘤患者中仍然是首选。

Several studies of multi-drug regimens for osteosarcoma have shown different efficacies and are still controversial. Meanwhile, chemotherapy options have remained largely unchanged over a couple of decades. This study is designed to ascertain the outcome and safety of Methotrexate, Doxorubicin, and Cisplatin regimen for chemotherapy in osteosarcoma patients through the utilization of meta-analysis.We interrogated trials that compared the MAP regimen with other regimens as chemotherapy for osteosarcoma from several databases encompassing PubMed, Science Direct, and grey literature (Google Scholar) until December 2022. The analyzed outcomes including Event-Free Survival (EFS), Overall Survival (OS), Tumor Necrosis (TN) rate, and Adverse Event (AE) were then analyzed using RevMan 5.4 software in fixed or random effect models.Our meta-analysis comprised 8 prospective articles that evaluated a cumulative number of 2920 OS patients. The analysis results indicated no meaningful difference in 5-year EFS (OR=0.99, 95% CI=0.77-1.27, [P = 0.91]) and neoadjuvant chemotherapy response (TN) (OR=0.76, 95% CI=0.49-1.17, [P = 0.22]) between the MAP and control groups. Furthermore, 5-year OS analysis revealed a significant association in the control group (OR=0.82, 95% CI=0.68-0.99, [P = 0.04]). However, the control group was associated with statistically meaningful AE compared to the MAP group, particularly in thrombocytopenia (OR=0.46, 95% CI=0.23-0.90, [P = 0.02]) and fever (OR=0.34, 95% CI=0.26-0.46, [P < 0.00001]).The present meta-analysis showed that the MAP regimen remains preferable in treating osteosarcoma patients despite no significant outcome compared to the other regimens considering the less frequent AE in the MAP regimen.