Abstract: Objective:To investigate the short-term effects and adverse reactions of the large dose of methotrexate(MTX),cisplatin(PPD) combined with adriamycin(ADR) in the chemotherapy of osteosarcoma.Methods:Thirty extremity osteosarcoma patients(ⅡB phase) diagnosed by histopathology and imaging were investigated.All patients were treated with the high dose of MTX,PDD combined with ADR,21 days for a cycle.The artificial joint replacement or amputation were implemented according to the MRI and plain film of lesions after 3 to 4 cycles of treatment.The curative effects were evaluated by the salvage success rate and tumor tissue necrosis rate according to the postoperative osteosarcoma pathological examination.Results:The tumor necrosis in more than 90% patients was identified by the result of postoperative pathological examination of osteosarcoma,the rates of tumor necrosis and salvage success were 86.7% and 53.0%,respectively.All the incidences of nausea and vomiting,hair loss and neutrophilopenia were 100.0%.The rates of hemoglobin reducing and white blood cell increasing were 86.7% and 16.7%,respectively.The incidences of oral and intestinal mucositis,and liver dysfunction were 26.7% and 13.3%,respectively.Conclusions:The treatment of osteosarcoma with high dose MTX,PDD combined with ADR is high tumor tissue necrosis and limb salvage rate,good curative effect and tolerable adverse reactions,which is worthy of clinical use.