Treatment of childhood post-irradiation sarcoma of bone in cancer survivors

• Published in: Medical and pediatric oncology Vol. 29; no. 6; pp. 568 - 572
• Main Authors: Cefalo, Graziella, Ferrari, Andrea, Tesoro-Tess, John D., Gianni, Maria C., Fossati-Bellani, Franca, Lombardi, Fabrizio, Massimino, Maura
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01-12-1997; Wiley-Liss
• Subjects: Adolescent; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bone Neoplasms - drug therapy; chemotherapy; Child; Child, Preschool; childhood cancer survivors; Cisplatin - administration & dosage; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Female; Humans; Ifosfamide - administration & dosage; Leucovorin - administration & dosage; Male; Medical sciences; Methotrexate - administration & dosage; Miscellaneous; Neoplasms, Radiation-Induced - drug therapy; Neoplasms, Second Primary - drug therapy; Pharmacology. Drug treatments; post-irradiation bone sarcoma; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Remission Induction; Retrospective Studies; Rhabdomyosarcoma - radiotherapy; Sarcoma - drug therapy; Sarcoma, Ewing - radiotherapy; Survivors; Vincristine - administration & dosage; Human; Antineoplastic agent; Sarcoma; Diseases of the osteoarticular system; Malignant tumor; Radiotherapy; Long term; Chemotherapy; Treatment; Adolescent; Complication; Combined treatment; Bone; Child
• ISSN: 0098-1532; 1096-911X
• DOI: 10.1002/(SICI)1096-911X(199712)29:6<568::AID-MPO9>3.0.CO;2-I

Patients and Methods
This is a retrospective review of five children with post‐irradiation bone sarcoma (PIS). Age at PIS onset ranged between 10 and 17 years (median 11). They were treated with a chemotherapy regimen, similar to that in use for primary osteogenic sarcoma, consisting of vincristine and high‐dose methotrexate alternated with cisplatinum and ifosfamide, given for 12 months.
Results
In all children chemotherapy induced a complete clinical remission. Four of them were alive in continuous complete remission at 1, 2, 4, and 12 years from the diagnosis of bone sarcoma. One girl recurred 3 years from PIS diagnosis and was salvaged by repeating the same chemotherapy program: she remained alive in second complete remission 8 years from relapse.
Conclusions
In spite of an intensive treatment previously given for the primary tumor, this drug schedule proved to be feasible and short‐term side effects were manageable. Chemotherapy alone, using an intensive regimen effective for primary osteogenic sarcoma, may be an adequate therapy for childhood post‐irradiation sarcoma. Med. Pediatr. Oncol. 29:568–572, 1997. © 1997 Wiley‐Liss, Inc.