Volume 70, Issue S8
November 2023
EP362/#1051 Poster Topic: AS05 SIOP Scientific Program/AS05.g Bone Tumours
TREATMENT OF RECURRENCE OF OSTEOSARCOMA IN CHILDREN
Vadym Kobys1, Sergej Savertulenko1, Vladymyr Konovalenko2, Oksana Ivasuk1, Olja Matuschok1, Oleg Nesterov1, Marina Dovgenko1
1Kyiv Cancer Center, Children, Kyiv, Ukraine, 2Institute of Experimental Pathology, Oncology and Radiobiology, Osteology, Kyiv, Ukraine
Background and Aims: The results of treatment of recurrence of osteosarcoma depend on the operability of the tumor, the interval of occurrence of relapse, the use of chemotherapy.
Methods: From 2009 to 2022, 19 children with relapsed osteogenic sarcoma, aged from 9 to 18 years, were treated in the children’s department of the Kyiv Oncology Center, the average age was 14 years. Recurrences were observed in 11 of 33 children with a local form of osteosarcoma and in 8 of 13 children with metastatic osteosarcoma. The number of relapses in one patient was from 1 to 8. In case of single metastases in the lungs, an atypical lung resection was performed, in case of multiple metastases in the lungs and bone metastasis, preoperative chemotherapy, removal of metastases, and postoperative chemotherapy were performed. Chemotherapy and surgery were performed in 6 children with recurrence of the local form of osteosarcoma, in 4 only atypical lung resection, in 1 child the parents refused treatment. 8 patients with metastatic osteosarcoma and combined relapse underwent chemotherapy. Primary chemotherapy was carried out according to protocol ISG-SSG 1 or UNDIOR-99. Relapse chemotherapy was based on 1st line chemotherapy drugs: methotrexate 12g/m2, ifosfamide 15g/m2, carboplatin 600 mg/m2 + etoposide 600 mg/m2 and 2nd line of chemotherapy: endoxan 2.5g/m2 + etoposide 500 mg/m2. Gemzar with docetaxel was used in adjuvant chemotherapy.
Results: Out of 11 children with recurrence of local osteosarcoma, 7 children (63.6%) remain alive with a follow-up period of 6 months to 12 years. 5-year overall survival was 68% (p<0.05). All children with recurrence of metastatic osteosarcoma died within 8 months to 7 years from the start of anti-relapse treatment.
Conclusions: The effectiveness of first-line chemotherapy is an important prognostic indicator (p <0.05) of the survival of children with relapsed osteogenic sarcoma.
