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.

Purpose: Treatment results in patients with Ewing tumors of the vertebrae were analyzed.

Patients and Methods: Between June 2000 and April 2007 7 patients with primary tumors of the thoracic or lumbar vertebrae were treated. No one patient had primary tumor of the cervical vertebra. The median ageat diagnosis was 13 years (range, 12 to 18 yrs.). Primary sites: thoracic5, lumbar 2. No one had metastases at diagnosis. Surgery was performed in 5 pts. Complete surgical excision in 2 and maximal tumor reduction in 3.Only biopsy was in 2pts. After surgery all pts. received chemotherapy: EICESS 92 (EVAIA chemotherapy regimen) in 4 pts. and Euro Ewing 99 in 3 pts. Radiotherapy was performed in 6 patients: after 2 cycles of chemotherapy in 2 pts., after 3 cycles in 4 pts. Median dose 5040cGy (range 5018–5400cGy) in conventional fractionation. Daily fractionation from 180–193cGy.

Results/Discussion: The mean follow-up was 41 months (range 4–104 months). Overall survival (OS) rate was 71,42 %. One patient progressed and died after complete treatment, another one died during chemotherapy before radiotherapy. In our series of Ewing’s Sarcoma of the vertebrae, good surgery initialy, early definitve radiotherapy and aggressive multimodal therapy (surgery/radiotherapy/chemotherapy) may be effective in disease control and survival.