Treatment of childhood post-irradiation sarcoma of bone in cancer survivors.
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.
Cefalo
G
G
Division of Pediatric Oncology, Istituto Nazionale Tumori, Milano, Italy.
Ferrari
A
A
Tesoro-Tess
J D
JD
Gianni
M C
MC
Fossati-Bellani
F
F
Lombardi
F
F
Massimino
M
M
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009381:Neoplasms, Radiation-Induced / Q000188:drug therapy*; D016609:Neoplasms, Second Primary / Q000188:drug therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000532:radiotherapy; D012509:Sarcoma / Q000188:drug therapy*; D012512:Sarcoma, Ewing / Q000532:radiotherapy; D017741:Survivors; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D002945:Cisplatin; D002955:Leucovorin; D007069:Ifosfamide; D008727:Methotrexate