Abstract
Objective: The aim of our study was to evaluate results of chemotherapy regimens and analyse prognostics factors in children with relapse of osteosarcoma.
Patients and methods: From 2000–2007, we treated 57 patients with non metastatic osteosarcoma, median age 15,5 years (range 3–18). 29 pts relapsed. 26 pts with osteosarcoma relapse were treated, and 3 pts with OS relapse refused the treatment. In 24 pts pulmonary metastases were detected (7 solitary), while 2 pts had local relapse of disease. Disease free interval (DFI) was more than 1 year in 12 patients. Surgery was performed in 20 pts (17 thoracotomy, 3 amputation). Chemotherapy regimens administered were: HD IFO-VP16 (11 pts), HDMth/IFO-VP16 (6 pts), HDMth/Carbo-VP16 (9 pts).
Results : During 8–116 months follow up period (Me=32 mts), disease free suvival rate was 33.12%. There was no significant difference in survival in relation to the type of chemotherapy regimen applied.Prognostic factors that influenced survival were: presence of a solitary metastasis (p= 0.026), local relapse of disease (p= 0.002), completeness of resection (p=0.043) and DFIlonger than 1 year (p= 0.039).
Conclusion: The use of aggressive multimodal therapy (surgery/chemotherapy) and evaluation of prognostic factors are necessary for successful treatment in patients with osteosarcoma relapse. Chemotherapy regimen HD IFO-VP16 had better initial tumore response, but in longer follow up the survival rate was similar to other chemotherapy groups.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
