O1-10-1IFOSFAMIDE AND ETOPOSIDE AS A SALVAGE CHEMOTHERAPY FOR SMALL ROUND CELL SARCOMA

Abstract Background: Multidisciplinary treatments with systemic chemotherapies and local therapies were commonly performed as a standard treatment for small round cell sarcomas including osteosarcoma and rhabdomyosarcoma. However, an appropriate salvage therapy after the initial treatment failure has not been clarified. We examined the efficacy and the safety of salvage chemotherapy consisting of ifosfamide and etoposide (IE therapy) . Patients and methods: The present study selected 16 Japanese patients who were diagnosed as small round cell sarcoma at Department of Hematology and Oncology, Kyushu University Hospital from January 2008 through July 2013. Nine of 16 patients received IE therapy after the failure of the initial therapy. Efficacy and safety of IE therapy for these 9 patients were retrospectively analyzed. Results: Median age was 29 years and 6 were female of 9 patients included. 4 had osteosarcoma, 2 had Ewing's sarcoma and 3 had rhabdomyosarcoma. Primary sites were head and neck 4, abdominopelvic 4 and mediastinum 1. Among 8 patients who had evaluable lesions, 5 showed stable disease and 3 showed progressive disease. Median progression free survival was 43 days and median overall survival was 435 days. Common grade 3/4 hematological toxicities were neutropenia 78%, febrile neutropenia 44%, anemia 33% and thrombocytopenia 33%. Non-hematological toxicities were manageable and one grade 3 nausea and elevation of serum creatinine were observed. Conclusions: IE therapy in the salvage setting for small round cell sarcomas should be carefully performed considering hematological adverse events.