Late effects of chemotherapy and radiotherapy in osteosarcoma and Ewing sarcoma patients

Cancer - Tập 118 Số 20 - Trang 5050-5059 - 2012
Alessandra Longhi1, Stefano Ferrari1, Angela Tamburini2, Roberto Luksch3, Franca Fagioli4, Gaetano Bacci1, Cristina Ferrari1
1Musculoskeletal Department, Chemotherapy Service, Rizzoli Orthopedic Institute, Bologna, Italy
2Meyer Pediatric Oncology Institute, Florence, Italy
3Department of Pediatric Oncology, National Cancer Institute, Milan, Italy
4Department of Pediatric Oncology, Regina Margherita Hospital, Turin, Italy

Tóm tắt

AbstractBACKGROUND:Patients with osteosarcoma and Ewing sarcoma have achieved longer survival over the past decades, but late side effects of chemotherapy and radiotherapy have become important concerns.METHODS:The authors reviewed all patients with localized osteosarcoma or Ewing sarcoma who had been enrolled in the Italian Sarcoma Group neoadjuvant protocols from 1983 through 2006. Data were updated in December 2010 to determine 3 endpoints: the incidence of a secondary primary cancer (designated as “second malignant neoplasm” [SMN]), infertility, and cardiotoxicity.RESULTS:Data were available on 883 patients with osteosarcoma and 543 patients with Ewing sarcoma. In the osteosarcoma group, there were 39 SMNs (4.4%) in 36 patients; in the Ewing sarcoma group, 15 patients (2.8%) experienced a single SMN each. The cumulative 10‐year and 20‐year incidence of an SMN (±standard error) was 4.9% ± 0.9% and 6.1% ± 1.2%, respectively, in the osteosarcoma group and 3.4% ± 0.9% and 4.7% ± 1.6%, respectively, in the Ewing sarcoma group. The most common SMN in the osteosarcoma group was breast cancer (n = 11), and the most common SMN in the Ewing sarcoma group was radiotherapy‐induced osteosarcoma (n = 6). After 20 years, the risk of developing an SMN increased, whereas the risk of a recurrence of the primary tumor decreased. Permanent sterility was more common in males than in females. Doxorubicin cardiotoxicity occurred in 18 patients with osteosarcoma (2%) and in 7 patients with Ewing sarcoma (1.3%).CONCLUSIONS:The awareness of late side effects in long‐term survivors of primary bone cancers should encourage longer follow‐up. Cancer 2012. © 2012 American Cancer Society.

Từ khóa


Tài liệu tham khảo

10.1016/j.ejca.2005.08.026

10.7326/0003-4819-152-7-201004060-00005

10.1097/01.mph.0000183270.28785.33

10.1002/1097-0142(19900601)65:11<2539::AID-CNCR2820651125>3.0.CO;2-M

10.1200/JCO.2000.18.24.4016

10.1177/030089169908500607

10.1016/S0959-8049(01)00229-5

10.1179/joc.2002.14.2.198

10.1200/JCO.2004.00.5785

FerrariS CefaloG TamburiniA et al. Nonmetastatic osteosarcoma of the extremity: neoadjuvant chemotherapy with methotrexate (MTX) cisplatin (CDP) doxorubicin (ADM) with or without ifosfamide (IFO)—a randomized trial of the Italian Sarcoma Group (ISG/OS‐1). Paper presented at: Annual Meeting of the American Society of Clinical Oncology; June 4‐8 2010; Chicago IL.

Bacci G, 1991, Nonmetastatic Ewing's sarcoma: results in 98 patients treated with neoadjuvant chemotherapy, Ital J Orthop Traumatol., 17, 449

Bacci G, 1995, Neoadjuvant treatment of Ewing's sarcoma: results obtained in 122 patients treated with a 6‐drug chemotherapeutic protocol (vincristine, Adriamycin, cyclophosphamide, dactinomycin, ifosfamide and etoposide) [article in Italian], Minerva Pediatr., 47, 457

10.1016/S0959-8049(02)00148-X

10.1093/annonc/mdq573

Kalbfleisch JD, 1980, The Statistical Analysis of Failure Time Data

10.1056/NEJMsa060185

10.1093/jnci/93.8.618

10.1002/cncr.21249

10.1002/cncr.25446

10.7326/0003-4819-141-8-200410190-00006

10.3324/haematol.11310

10.1016/S0140-6736(09)61885-7

10.1093/jnci/djq278

10.1056/NEJM199506293322602

10.1097/00043426-200304000-00005

10.1002/1097-0142(20001101)89:9<1961::AID-CNCR12>3.0.CO;2-8

10.1200/JCO.2010.33.7808

10.1016/j.gyobfe.2011.02.007

10.1002/1097-0142(19910915)68:6<1221::AID-CNCR2820680607>3.0.CO;2-R

Pratt CB, 1978, Age‐related Adriamycin cardiotoxicity in children, Cancer Treat Rep., 62, 1381

10.1200/JCO.1997.15.4.1544

Thông tin
Thông tin xuất bản

Cancer

Tập 118 Số 20

5050-5059

Thông tin tác giả