This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bramwell, V. H.C. Articles by Van Glabbeke, M. M. Search for Related Content PubMed PubMed Citation Articles by Bramwell, V. H.C. Articles by Van Glabbeke, M. M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Bone Cancer Hazardous Substances DB CIS-DIAMINEDICHLOROPLATINUM DOXORUBICIN PLATINUM COMPOUNDS Social Bookmarking                            What's this?

Neoadjuvant Chemotherapy With Doxorubicin and Cisplatin in Malignant Fibrous Histiocytoma of Bone: A European Osteosarcoma Intergroup Study

From the London Regional Cancer Centre, London, Ontario, Canada; Leicester Royal Infirmary, Leicester, University College London Hospitals National Health Service Trust, London, Royal Victoria Infirmary, Newcastle upon Tyne, Royal Orthopaedic Hospital National Health Service Trust, Birmingham, Royal National Orthopedic Hospital, London, and Medical Research Council Cancer Trials Office, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, the Netherlands; and European Organization for Research and Treatment of Cancer Data Centre, Brussels, Belgium.

Address reprint requests to Vivien H.C. Bramwell, MD, PhD, London Regional Cancer Centre, 790 Commissioners Rd, E, London, Ontario, Canada N6A 4L6; email vbramwell{at}lrcc.on.ca

PURPOSE: Studies involving small case series have suggested that malignant fibrous histiocytoma of bone (MFH-B) is a chemosensitive tumor and that chemotherapy may improve survival. In this study, we evaluated clinical and pathologic response rates and survival in a series of patients treated with a consistent chemotherapy regimen of doxorubicin and cisplatin (DOX/DDP).

PATIENTS AND METHODS: Study patients were required to have biopsy-proven MFH-B, no previous chemotherapy, and primary or metastatic measurable disease and to be 65 years of age. Treatment consisted of doxorubicin 25 mg/m²/d days 1 through 3 and cisplatin 100 mg/m² by 4-hour intravenous infusion every 3 weeks for six cycles. In patients with operable primary tumors, chemotherapy was planned to start within 42 days of biopsy, with definitive surgery performed after three cycles.

RESULTS: Forty-one patients had operable nonmetastatic limb sarcomas, and 23 (56%) completed six chemotherapy cycles. Limb salvage was possible in 33 patients (80%), and 16 (42%) of 38 assessable specimens showed a good pathologic response ( 90% necrosis). Median time to progression was 56 months, and the 5-year progression-free survival rate was 56% (95% confidence interval [CI], 40% to 72%). Median survival time was 63 months, and the 5-year survival rate was 59% (95% CI, 41% to 77%). Patients with a good pathologic response had longer survival times and times to progression than did those with a poor response. Also treated were two patients with locally recurrent and nine with metastatic disease, and these patients had a median survival time of 17.5 months.

CONCLUSION: Our study suggests that adjuvant or neoadjuvant chemotherapy with DOX/DDP is beneficial in MFH-B. Good pathologic response rates and survivals are quite comparable with those for osteosarcoma, a related bone tumor for which adjuvant or neoadjuvant chemotherapy is an accepted practice.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. M. Skubitz and D. R. D'Adamo Sarcoma Mayo Clin. Proc., November 1, 2007; 82(11): 1409 - 1432. [Abstract] [Full Text] [PDF]

				P. J. Papagelopoulos, A. F. Mavrogenis, E. C. Galanis, G. D. Chloros, and K. Th. Papaparaskeva Malignant Fibrous Histiocytoma of Bone Associated with Type-1 Neurofibromatosis. A Case Report J. Bone Joint Surg. Am., February 1, 2005; 87(2): 399 - 403. [Full Text] [PDF]