POSTSURGICAL ETOPOSIDE-IFOSFAMIDE REGIMEN IN POOR-RISK NONMETASTATIC OSTEOGENIC-SARCOMA

This prospective study was designed to test the activity of an ifosfam ide-etoposide (VP-16) regimen on poor-risk, nonmetastatic, osteogenic sarcoma. A total of 13 patients with nonmetastatic osteogenic sarcoma with a poor histologic response to primary high-dose methotrexate-doxo rubicin (Adriamycin)-cisplatinum chemotherapy received a total of six 5-day courses of ifosfamide (1,800 mg/m(2)) and etoposide (100 mg/m(2) ) at three weekly intervals. The protocol was well tolerated, with onl y one case of transient renal failure, At present, eight patients (62% ) have been in sustained complete remission with no evidence of recurr ent disease for a mean follow-up of 3.4 years (range, 1.5-7.0 years). One patient is alive with lung metastases, and four have died of progr essive disease. This prospective, albeit small, study confirms the eff icacy of an ifosfamide-VP-16-based regimen in poor-risk, extremity, no nmetastatic osteogenic sarcoma. The demonstrated activity should spark large trials of ifosfamide-containing regimens in osteogenic sarcoma.