Synovial Sarcoma in Children

Have you seen the recent St. Jude’s commercial on TV? The images just break your heart, and I can’t imagine facing that reality on a daily basis. I’ve watched several people fall apart as their child lost his or her battle with leukemia, and it is emotionally devastating. Kudos to all the pediatric oncologists out there — it takes a special kind of person to live in that world.

Thinking about it made me want to take an earnest jog through the ASCO abstracts and see what the news was for pediatric conditions. Are there any readers out there who got to attend? Ironically, one of the very first studies that I ran across was one from St. Jude’s, addressing the role of chemotherapy in cases of relapsed osteosarcoma. There were several presentations addressing rhabdomyosarcoma (RMS) and Ewing’s sarcoma; I’m not sure whether there was any terrible new ideas on the RMS side of things, but there was an interesting study of Ewing’s sarcoma that suggests shorter/more time intensive cycles of chemotherapy may be the way to go. The study looked at the efficacy and tolerability of a regimen of vincristine/doxorubicin/cyclophosphamide alternating with cycles of ifosfamide/etoposide given to a group of 284 patients every two weeks, and given to the same number of patients in a different group every three weeks. What they found was that treatment was more effective in the 2-week group, and, surprisingly enough, the occurrence of side effects and number of hospital days were similar between groups.

Another interesting study addressed the treatment of synovial sarcoma, a soft tissue malignancy that is evidently about as rare as rhabdomyosarcoma is common. Currently, treatment most frequently involves tumor resection with or without radiotherapy, and less commonly, chemotherapy is used. The point being, as pointed out in the study abstract, that an optimal treatment really hasn’t been identified. Here, the researchers looked retrospectively at 250 cases which occurred at a single institution (the Rizzoli Institute in Bologna, Italy) over a 30-year period. They found that localized tumors were good news in terms of prognosis, and this held true for recurring tumors. The use of radiotherapy significantly improved prognosis, but ifosfamide and/or doxorubicin-based chemotherapy did not.

That’s it for me. Anybody who took note of other meaningful studies please do feel free to let the rest of us know. In the meantime, I’m putting a box of Kleenex on the coffee table just in case the St. Jude’s commercial comes on again during what little time I have in front of the TV.