Systemic Therapy for Osteosarcoma and Ewing Sarcoma
Addition of ifosfamide and etoposide to treatment for patients with poor initial response to therapy does not improve outcome.
Systemic therapy for osteosarcoma consists of multi‑agent chemotherapy (cisplatin, doxorubicin, high‑dose methotrexate). Addition of ifosfamide and etoposide to treatment for patients with poor initial response does not improve outcome, nor does interferon for favorable response. Liposomal muramyl tripeptide may improve overall survival. For Ewing sarcoma, multi‑agent regimens (doxorubicin, vincristine, etoposide, cyclophosphamide, ifosfamide) with increased dose intensity improve outcomes; irinotecan/temozolomide or cyclophosphamide/topotecan show activity in metastatic recurrent disease. Ongoing trials assess adding these agents and high‑dose systemic therapy with autologous stem‑cell reconstitution.
Optimizing systemic chemotherapy regimens is critical for achieving cure in osteosarcoma and Ewing sarcoma, directly impacting patient survival and informing clinical practice guidelines.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.
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- Future Directions in the Treatment of Osteosarcoma
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- Amputation and Chemotherapy for Osteosarcoma