TY - JOUR
T1 - EURO-B.O.S.S.
T2 - A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma
AU - Ferrari, Stefano
AU - Bielack, Stefan S.
AU - Smeland, Sigbjørn
AU - Longhi, Alessandra
AU - Egerer, Gerlinde
AU - Sundby Hall, Kirsten
AU - Donati, Davide
AU - Kevric, Matthias
AU - Brosjö, Otte
AU - Comandone, Alessandro
AU - Werner, Mathias
AU - Monge, Odd
AU - Palmerini, Emanuela
AU - Berdel, Wolfgang E.
AU - Bjerkehagen, Bodil
AU - Paioli, Anna
AU - Lorenzen, Sylvie
AU - Eriksson, Mikael
AU - Gambarotti, Marco
AU - Tunn, Per Ulf
AU - Jebsen, Nina L.
AU - Cesari, Marilena
AU - von Kalle, Thekla
AU - Ferraresi, Virginia
AU - Schwarz, Rudolf
AU - Bertulli, Rossella
AU - Kasparek, Anne Katrin
AU - Grignani, Giovanni
AU - Krasniqi, Fatime
AU - Sorg, Benjamin
AU - Hecker-Nolting, Stefanie
AU - Picci, Piero
AU - Reichardt, Peter
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Adult osteosarcoma
KW - Chemotherapy
KW - Chemotherapy-related toxicity
KW - Osteosarcoma
UR - http://www.scopus.com/inward/record.url?scp=85046434139&partnerID=8YFLogxK
U2 - 10.5301/tj.5000696
DO - 10.5301/tj.5000696
M3 - Article
C2 - 29218692
AN - SCOPUS:85046434139
SN - 0300-8916
VL - 104
SP - 30
EP - 36
JO - Tumori
JF - Tumori
IS - 1
ER -
