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Annals of Oncology 4:409-415, 1993
© 1993 European Society for Medical Oncology

research-article

Chemotherapy of malignant fibrous histiocytoma of bone

H. M. Earl1, J. Pringle2, H. Kemp2, L. Morittu1, D. Miles1 and R. Souhami1,

1Department of Oncology, UCL Medical School London
2Institute of Orthopaedics, Royal National Orthopaedic Hospital Stanmore, Middlesex, U.K

Correspondence to: R. L. Souhami, M.D., F.R.C.P., Department of Oncology, University College London Medical School, Middlesex Hospital, Mortimer Street, London, W1N 8AA, U.K.

BACKGROUND:: Malignant fibrous histiocytoma of bone (MFHB) is a rare tumour with a 3 year survival of 30%-40% when treated with surgery alone. A small number of patients have previously been treated with pre-operative chemotherapy and responses observed. The aim of the present study was to further determine the response of MFHB to pre-operative chemotherapy.

PATIENTS AND METHODS:: A non-randomised study of 18 patients with MFHB. Twelve had localised disease and 6 had pulmonary metastases. In 14 patients pre-operative treatment consisted of methotrexate 8 g/m2 on day 1, ifosfamide 3 g/m2 and doxorubicin 60 mg/m2 on day 10. This regimen was given twice and twice post-operatively. A further 4 patients received cisplatin 100 mg/m2 on day ] and doxorubicin 25 mg/m2 on days 1, 2, 3. Three cycles were given preand post-operatively.

RESULTS:: 15 patients had surgery after chemotherapy. Tumour necrosis was present in all resection specimens and ranged from 50%–100%. 7/15 had >90% necrosis. Disease free survival is 82% for those patients with a greater than 2 year follow-up.

CONCLUSION:: This study confirms previous reports that MFHB is a chemosensitive tumour. In view of its rarity collaborative trials are needed to establish the optimum drug treatment including drug selection dose and duration.

bone sarcoma, chemotherapy


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