Journal article
EURO-B.O.S.S.: A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma.
- Ferrari S 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Bielack SS 2 Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany.
- Smeland S 3 Division of Cancer Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo - Norway.
- Longhi A 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Egerer G 4 Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital, Heidelberg - Germany.
- Sundby Hall K 3 Division of Cancer Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo - Norway.
- Donati D 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Kevric M 2 Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany.
- Brosjö O 5 Department of Orthopedics, Karolinska University Hospital, Stockholm - Sweden.
- Comandone A 6 Oncology Department, Ospedale Humanitas-Gradenigo, Turin - Italy.
- Werner M 7 Department of Orthopedic Pathology, HELIOS Klinikum Emil von Behring GmbH, Berlin - Germany.
- Monge O 8 Department of Oncology and Radiotherapy, Haukeland University Hospital, Bergen - Norway.
- Palmerini E 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Berdel WE 9 Department of Medicine A, University Hospital of Muenster, Muenster - Germany.
- Bjerkehagen B 3 Division of Cancer Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo - Norway.
- Paioli A 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Lorenzen S 10 Department of Hematology and Oncology, Klinikum rechts der Isar der TU Muenchen, Muenchen - Germany.
- Eriksson M 11 Department of Oncology, Skane University Hospital and Lund University, Lund - Sweden.
- Gambarotti M 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Tunn PU 12 Department of Tumor Orthopedics, HELIOS Klinikum Berlin-Buch, Berlin - Germany.
- Jebsen NL 13 Department of Clinical Science, Haukeland University Hospital and Center for Cancer Biomarkers CCBIO, University of Bergen, Bergen - Norway.
- Cesari M 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- von Kalle T 2 Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany.
- Ferraresi V 14 Oncology Department, Istituto Regina Elena, Rome - Italy.
- Schwarz R 15 Department of Radiation Oncology, Medical Center Hamburg-Eppendorf, Hamburg - Germany.
- Bertulli R 16 Oncology Department, Istituto Nazionale Tumori, Milan - Italy.
- Kasparek AK 17 Department of Internal Medicine, Division of Oncology, Medical University of Graz, Graz - Austria.
- Grignani G 18 Oncology Department, Istituto di Candiolo IRCCS, Turin - Italy.
- Krasniqi F 19 Oncology Deparment, University Hospital of Basel, Basel - Switzerland.
- Sorg B 2 Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany.
- Hecker-Nolting S 2 Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany.
- Picci P 1 Oncology Department, Istituto Ortopedico Rizzoli, Bologna - Italy.
- Reichardt P 7 Department of Orthopedic Pathology, HELIOS Klinikum Emil von Behring GmbH, Berlin - Germany.
- 2017-12-09
Published in:
- Tumori. - 2018
Adult osteosarcoma
Chemotherapy
Chemotherapy-related toxicity
Osteosarcoma
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Bone Neoplasms
Cisplatin
Doxorubicin
Europe
Febrile Neutropenia
Female
Humans
Ifosfamide
International Cooperation
Male
Methotrexate
Middle Aged
Osteosarcoma
Prospective Studies
Survival Analysis
Treatment Outcome
English
INTRODUCTION
The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.
METHODS
Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.
RESULTS
The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.
CONCLUSIONS
In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.
The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.
METHODS
Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.
RESULTS
The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.
CONCLUSIONS
In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.5301/tj.5000696
- PMID 29218692
- Persistent URL
- https://sonar.ch/global/documents/92663
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