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Cited by 123Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsCardiac tumors and thrombi

EURO-B.O.S.S.: A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma

Ferrari, Stefano, Bielack, Stefan S., Smeland, Sigbjørn, Longhi, Alessandra, Egerer, Gerlinde, Sundby Hall, Kirsten, Donati, Davide, Kevric, Matthias +25 more·2018·Tumori Journal
DOI 10.5301/tj.5000696
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Abstract

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.

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Crossref · 10.5301/tj.5000696

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  • Considerable chemotherapy-related toxic effects were observed in the EURO-B.O.S.S. study, with neutropenia and other haematological adverse effects most frequent.

    “However, considerable chemotherapy-related toxic effects were observed; neutropenia and other haematological adverse effects were most frequent.”

    From Osteosarcoma (2022) · cites this paper as [133]

  • The EURO-B.O.S.S. study demonstrated a favourable 5-year probability of survival of 66% (95% CI 57-75%) in patients with localized disease receiving intensive multi-agent chemotherapy that included attenuated doses of methotrexate.

    “The EURO-B.O.S.S. study demonstrated a favourable 5-year probability of survival of 66% (95% CI 57-75%) in patients with localized disease receiving intensive multi-agent chemotherapy that included attenuated doses of methotrexate 133 .”

    From Osteosarcoma (2022) · cites this paper as [133]

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Authors
Ferrari, S., Bielack, S. S., Smeland, S., Longhi, A., Egerer, G., Sundby Hall, K., Donati, D., Kevric, M., Brosjö, O., Comandone, A., Werner, M., Monge, O., Palmerini, E., Berdel, W. E., Bjerkehagen, B., Paioli, A., Lorenzen, S., Eriksson, M., Gambarotti, M., Tunn, P.-U., Jebsen, N. L., Cesari, M., von Kalle, T., Ferraresi, V., Schwarz, R., Bertulli, R., Kasparek, A.-K., Grignani, G., Krasniqi, F., Sorg, B., Hecker-Nolting, S., Picci, P., & Reichardt, P.
Affiliations
  • Istituto Ortopedico Rizzoli (IT)
  • Olgahospital (DE)
  • Oslo University Hospital (NO)
  • University Hospital Heidelberg (DE)
  • Division of Cancer Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo - Norway
  • Karolinska University Hospital (SE)
  • Ospedale Humanitas Gradenigo (IT)
  • Helios Klinikum Emil von Behring (DE)
  • Haukeland University Hospital (NO)
  • University Hospital Münster (DE)
  • TUM Klinikum (DE)
  • Lund University (SE)
  • Helios Hospital Berlin-Buch (DE)
  • Stuttgart Cancer Center, Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart Olgahospital, Stuttgart - Germany
  • Instituto Nazionale Tumori Regina Elena (IT)
  • University Medical Center Hamburg-Eppendorf (DE)
  • Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
  • Medical University of Graz (AT)
  • Candiolo Cancer Institute (IT)
  • University Hospital of Basel (CH)
Corresponding author
Ferrari, Stefano
ORCID
Venue
Tumori Journal
Publisher
SAGE Publications
Published
2018-01
Volume
104
Issue
1
Pages
30-36
ISSN
  • 0300-8916 (ISSN-L)
  • 2038-2529
DOI
10.5301/tj.5000696
OpenAlex
W2772058283
Cited by
123
References
24
Citations by year
2026: 9 · 2025: 13 · 2024: 18 · 2023: 15 · 2022: 17 · 2021: 23 · 2020: 12 · 2019: 8 · 2018: 7
FWCI
6.10
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Tumori Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • mediaTUM (Technical University of Munich) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
Keywords
high-grade osteosarcoma, primary osteosarcoma, doxorubicin, cisplatin, ifosfamide, methotrexate, intensive chemotherapy, overall survival, synchronous metastases, pelvic tumors, chemotherapy toxicity, nephrotoxicity, neurotoxicity, hematologic toxicity, tumor necrosis
MeSH terms
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bone Neoplasms, Cisplatin, Doxorubicin, Europe, Female, Humans, Ifosfamide, International Cooperation, Male, Methotrexate, Middle Aged, Prospective Studies, Osteosarcoma, Survival Analysis, Treatment Outcome, Febrile Neutropenia

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