TREATMENT OF CHILDHOOD POSTIRRADIATION SARCOMA OF BONE IN CANCER SURVIVORS

Patients and Methods. This is a retrospective review of live children with post-irradiation bone sarcoma (PIS). Age at PIS onset ranged betw een 10 and 17 years (median 11). They were treated with a chemotherapy regimen, similar to that in use for primary osteogenic sarcoma, consi sting of vincristine and high-dose methotrexate alternated with cispla tinum and ifosfamide, given for 12 months. Results. In all children ch emotherapy induced a complete clinical remission. Four of them were al ive in continuous complete remission at 1, 2, 4, and 12 years from the diagnosis of bone sarcoma. One girl recurred 3 years from PIS diagnos is and was salvaged by repeating the same chemotherapy program: she re mained alive in second complete remission 8 years from relapse. Conclu sions. in spite of an intensive treatment previously given for the pri mary tumor, this drug schedule proved to be feasible and short-term si de effects were manageable. Chemotherapy alone, using an intensive reg imen effective for primary osteogenic sarcoma, may be an adequate ther apy for childhood post-irradiation sarcoma. (C) 1997 Wiley-Liss, Inc.