Maintenance Treatment with Trofosfamide in Patients with Primary Bone Ewing Sarcoma – Single Center Experience

BACKGROUND: Patients with Ewing sarcoma have a dismal outcome. Maintenance treatment with trofosfamide has been proposed as an effective regimen for same paediatric malignancies. AIM: We sought to evaluate the schedule of trofosfamide for patients with high-risk primary bone Ewing sarcoma. MATERIALS AND METHODS: Fifteen patients with primary bone Ewing sarcoma received treatment with trofosfamide (750 mg/m(2) p.o. days 1-10) every 28 days. All patients hod standard tumour imaging and laboratory evaluation. All toxicities were documented. RESULTS: A tatal of 90 cycles (median 5 cycles/patient) were administered. A complete response was maintained in nine patients, while six patients had disease progression during treatment Median time to progression was 7.9 months (range 1.8 to 4.6). Eleven patients (73.3%) are alive including nine with no evidence of disease with a median follow-up of 3.9 years (range 7.4 to 7.6). All patients with active disease at the start of the trofosfamide treatment died. There were no significant toxicities. CONCLUSIONS: Treatment with trofosfamide is well-tolerated and could have a role to maintain response in patients with primary bone Ewing sarcoma. Further studies are needed to better define the use of this regimen in the upfrront management of those patients.