title: Secondary tumors in bone sarcomas after treatment with chemotherapy.
abstract: New oncologic treatments have improved survival in osteosarcoma and Ewing's sarcoma. However, these treatments may cause secondary malignancies after radiotherapy. This study evaluated the incidence of secondary malignancies after neoadjuvant chemotherapy. Between April 1972 and December 1990, 518 osteosarcoma and 299 Ewing's sarcoma patients entered neoadjuvant chemotherapy protocols. Follow-up records of all patients were analyzed and malignant tumors were reported. Nine patients developed another malignancy, including 5 leukemias, 1 astrocytoma, 1 liposarcoma, 1 parotid, and 1 breast carcinoma. Four leukemias were found in patients treated for osteosarcoma with chemotherapy, but not radiotherapy. Only one leukemia developed after Ewing's sarcoma treated with chemotherapy and radiotherapy. The incidence of leukemias is high, while the other tumors can be explained as unrelated cases. Incidence densities for leukemia were calculated for both groups of patients. Treated osteosarcoma patients seem to have a predisposition to develop leukemias, but whether this is chemotherapy induced needs to be investigated.
authors.affiliation: Laboratory of Oncologic Research, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ferrari
authors.forename: T
authors.initials: T
authors.lastname: Bohling
authors.forename: M S
authors.initials: MS
authors.lastname: Benassi
authors.forename: A
authors.initials: A
authors.lastname: Ferraro
authors.forename: G
authors.initials: G
authors.lastname: Gamberi
authors.forename: G
authors.initials: G
authors.lastname: Bacci
authors.forename: A b
authors.initials: Ab
authors.lastname: Del prever
authors.forename: L
authors.initials: L
authors.lastname: Sangiorgi
authors.forename: P
authors.initials: P
authors.lastname: Ragazzini
authors.forename: M R
authors.initials: MR
authors.lastname: Sollazzo
authors.forename: A
authors.initials: A
authors.lastname: Balladelli
authors.forename: P
authors.initials: P
authors.lastname: Picci
mesh_terms: D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D001859:Bone Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology*; D012516:Osteosarcoma / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D012512:Sarcoma, Ewing / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D013997:Time Factors
chemical_list: D018906:Antineoplastic Agents, Alkylating