Treatment of childhood post-irradiation sarcoma of bone in cancer survivors

Med Pediatr Oncol. 1997 Dec;29(6):568-72. doi: 10.1002/(sici)1096-911x(199712)29:6<568::aid-mpo9>;2-i.


Patients and methods: This is a retrospective review of five children with post-irradiation bone sarcoma (PIS). Age at PIS onset ranged between 10 and 17 years (median 11). They were treated with a chemotherapy regimen, similar to that in use for primary osteogenic sarcoma, consisting of vincristine and high-dose methotrexate alternated with cisplatinum and ifosfamide, given for 12 months.

Results: In all children chemotherapy induced a complete clinical remission. Four of them were alive in continuous complete remission at 1, 2, 4, and 12 years from the diagnosis of bone sarcoma. One girl recurred 3 years from PIS diagnosis and was salvaged by repeating the same chemotherapy program: she remained alive in second complete remission 8 years from relapse.

Conclusions: In spite of an intensive treatment previously given for the primary tumor, this drug schedule proved to be feasible and short-term side effects were manageable. Chemotherapy alone, using an intensive regimen effective for primary osteogenic sarcoma, may be an adequate therapy for childhood post-irradiation sarcoma.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Leucovorin / administration & dosage
  • Male
  • Methotrexate / administration & dosage
  • Neoplasms, Radiation-Induced / drug therapy*
  • Neoplasms, Second Primary / drug therapy*
  • Remission Induction
  • Retrospective Studies
  • Rhabdomyosarcoma / radiotherapy
  • Sarcoma / drug therapy*
  • Sarcoma, Ewing / radiotherapy
  • Survivors
  • Vincristine / administration & dosage


  • Vincristine
  • Cisplatin
  • Leucovorin
  • Ifosfamide
  • Methotrexate