Evidence-Based Pediatric Oncology by Ross Pinkerton, A. G. Shankar, Katherine Matthay

By Ross Pinkerton, A. G. Shankar, Katherine Matthay

This publication is up-to-date with proof from the most recent released stories and is extra clinically concentrated, with an emphasis on software of the trial findings. With elevated insurance of trials within the sector of supportive take care of pediatric melanoma sufferers, each one bankruptcy opens with a scientific query and concludes with a precis at the trial findings from knowledgeable commentator.

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Cancer 1990;66:1703–10. 18 Bacci G, Ferrari S, Tienghi A et al. A comparison of methods of loco-regional chemotherapy combined with systemic chemotherapy as neo-adjuvant treatment of osteosarcoma of the extremity. Eur J Surg Oncol 2001;27:98–104. 17 Summary of previous studies The earliest study in osteosarcoma (OS) was the German COSS-80, testing (1) whether the addition of either cisplatin or bleomycin, cyclophosphamide, actinomycin D (BCD) improves the efficacy of a doxorubicin/high-dose methotrexate (HDMTX) regimen and (2) whether interferon is of benefit when given to patients following initial chemotherapy [1].

Patients who had received more than one prior chemotherapy treatment regimen, those with prior exposure to anthracyclines, ischemic heart disease, myeloablative chemotherapy, disease impinging on or within the brain and spinal cord and those who were pregnant or lactating were excluded. Patients with unfavorable prognosis (alveolar ­histology at initial diagnosis, stage 1 clinical group I embryonal histology diagnosis with distant ­recurrence, or stages 2, 3 or 4 and clinical group II, III or IV embryonal histology at initial diagnosis) were randomly assigned to one of two schedules of ­irinotecan combined with vincristine.

In both studies, only patients with responsive ­disease were eligible for high-dose therapy and a proportion of patients eligible for high-dose therapy did not undergo assigned therapy, raising the possibility of selection bias in these nonrandomized studies. The ­ Euro-Ewing 99 trial includes an ongoing study evaluating high-dose therapy in a randomized manner for patients with poor-risk tumors, including those with isolated pulmonary metastatic disease. The eagerly awaited results of this randomized trial will provide clarity about the role of high-dose therapy for Ewing sarcoma.

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