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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 475 - 475
1 Jul 2010
Hestanov D Igoshin A Shvarova A Ivanova N Aliev M
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The aim of the our study was to analyze prognostic factors characterizing biological behaviour of a tumour and specific features of the patient and to develop rational strategy of the combined treatment of chondrosarcoma (CHS) in children.

Between 1982 and 2008 seventy seven patients with CHS were observed and treated in our center. 38 (49,4%) were male and 39 (50,6%) were female. In all cases the diagnosis was confirmed by histological examination. In cases of high grade/mesenchymal or metastatic (into lungs) CHS we use polychemotherapy consist of alternating courses of CDDP, adriamicin, ifosfamide and etoposide and high-dose methotrexate (8–12 g/m2). Intensive polychemotherapy allow us to expand indications for limb salvage treatment. Using growing (conventional and non-invasive types) endoprostesis improved the quality of life. 5-years RFS was 75,4±7,8 % (Kaplan-Meier curves, p=0.02). The most significant prognostic factors were grade of histological response, morphological type of tumour and type of polychemotherapy (conventional or intensive)


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 434 - 434
1 Jul 2010
Igoshin A Shvarova A Ivanova N Aliev M
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We analyzed the results of the intensive multimodality therapy of children with localized Ewing’s family tumors of the ribs (EFTR). 22 patients with localized EFTR were treated in our institute between 1996 and 2006. The age is ranged from 4 to 15 years. 10 patients were male, 12 – female. Eight patients had a classic Ewing sarcoma(ES), 14 – PNET. The high risk criterion was tumor volume over 100 ml. The treatment plan included intensive induction chemotherapy (adapted to risk group) consist of 5 courses (1, 3, 5 courses – vincristine, adriamicin, cyclophosphamide, 2, 4 courses – ifosfamide and etoposide) and local control (surgery and radiotherapy), and consolidation with or 5 courses standard therapy or high-dose chemotherapy with stem-cell rescue. 4 patients underwent high-dose chemotherapy, 18 – consolidation with standard arm.

Two patients died from complications of chemotherapy, 20 patients completed the treatment. 5-year overall survival (OAL) of patients was 70±10,4%, 5-year event-free survival (EFS) was 58,9±11,4%. We conclude that Ewing’s family tumors are the most common tumors of ribs in childhood. Improved EFS requires more aggressive systemic chemotherapy and surgery (removing of entire affected ribs). Long-term survival is possible, even for high risk patients.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 463 - 463
1 Jul 2010
Hestanov D Igoshin A Shvarova A Ivanova N Aliev M
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The purpose of the our study was to analyze prognostic factors characterizing biological behaviour of a tumour and specific features of the patient and to develop rational strategy of the combined treatment of malignant fibrous histiocytoma (MFH) in children.

Between 1982 and 2008 fifty patients with MFH were observed and treated in our center. 24 (48%) were male and 26 (52%) were female. In all cases the diagnosis was confirmed by histological examination. We use polychemotherapy consist of alternating courses of CDDP, adriamicin, ifosfamide and etoposide and high-dose methotrexate (8–12 g/m2). Intensive polychemo-therapy allow us to expand indications for limb salvage treatment. Using growing (conventional and non-invasive types) endoprostesis improved the quality of life. 2-years RFS was 80,9±8,5% and 5-years RFS was 70,4±10,1% (Kaplan-Meier curves, p=0.03). The most significant prognostic factors were grade of histological response and type of polychemotherapy (conventional or intensive).


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 436 - 436
1 Jul 2010
Shvarova A Savlaev K Kubirov M Igoshin A Ivanova N Aliev M
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The aim of our study was to increase of survival of children with osteosarcoma by intensification of chemotherapy by inclusion of high dose methotrexate. 53 patients were treated in our centre between 2003 and 2007. Age are ranged from 5 to 16 years. 23 (43,4%) patients had metastetic disease. Polychemotherapy consist of alternating courses of CDDP, adriamicin, ifosfamide and etoposide and high-dose methotrexate (8–12 g/m2). In 25 (51%) cases have been received objective response (CR+PR). 38 (71,7%) patients alive at present time. 2 patients died from complications of treatment. 7 patients had PD, 1 — local relapse, 4 — metastatic relapse, 1 — combined relapse. 2-year OAS was 75,2±6,8%, 2-year RFS was 65±7,8%.