Real-life analysis of chemotherapy treatment for bone tumors and soft tissue sarcomas at the Luis Guillermo Ibarra National Rehabilitation Institute (Ibarra)

Abstract

Real-world study of chemotherapy in bone tumors and soft tissue sarcomas
conducted at the Instituto Nacional de Rehabilitación Luis Guillermo Ibarra
Ibarra
Introduction: Bone tumors (BT) and soft tissue sarcomas (STS) are rare tumors that represent a diagnostic
and therapeutic challenge. Chemotherapy is a primordial treatment in high-grade or non-resecable tumors,
although efficacy is limited. It is relevant to evaluate current treatments in the local population, to promote
evidence to lead clinical decisions and optimized protocols.
Objective: This study aims to know the indications and efficacy of chemotherapy regimens delivered in
Musculoskeletal Tumors Departments (STMS, in Spanish) in the National Rehabilitation Institute Luis
Guillermo Ibarra Ibarra.
Methods: It was conducted a retrospective revision of electronic institutional clinical records and
chemotherapy compounding center prescriptions, from January 1st 2020 to 31st December 2024. Patients over
16 years old treated at STMS were included. Patients whose chemotherapy regimen was not completed in the
institute were excluded. A statistical descriptive analysis of clinical and sociodemographic patients’
characteristics, administered chemotherapeutic drugs, total number of cycles, median overall survival. An
overall survival analysis was made with Kaplan-Meier curves. All data collected were processed in IBM SPSS
Statistics, version 31rd.
Results: During the study period, 46 patient records were found from those treated at the STMS and received
chemotherapy, 5 were excluded. Of the 41 patients included, 18 (43.9%) were women and 23 (56.1%) men; 24
single, 12 married and 5 cohabiting. The majority had completed high school and resided in the State of
Mexico. Most were beneficiaries of INSABI, 27 (65.9%), homemakers 16 (39%), unemployed 7 (17.1%),
student 6 (14.6%), worker 9 (22%), retired 3 (7.3%). Stage II and III were the most commonly diagnosticated;
22% were staging as IV at diagnosis. Osteosarcoma was the most frequent tumor: 26 (65.9%), 8 (19.5%) with
multiple myeloma (MM), 4 (9.8%) STS and 2 (4.9%) Ewing’s sarcoma. 24 (58.5%) were localized disease, 9
(22%) with metastasis. 28 patients went under surgery: 19 radical surgeries and 9 limb-sparing surgeries.
Neoadjuvant chemotherapy number of cycles administrated went from 1 to 4, the most used treatments were
doxorubicin and cisplatin; ifosfamide (IFO) and etoposide; IFO combined with vincristine, cyclophosphamide,
and actinomycin. As an adjuvant treatment, the number of cycles ranged from 1 to 6, using combinations
based on IFO and the gemcitabine/carboplatin. In MM, bortezomib and talidomide were the most frequent
regimen, ranging from 1 to 12 cycles. The median overall survival was 29.7 months (IC95% 19.93-39.47).
The most frequent side effects were neutropenia and surgical wound infection; one patient died due to fever
and neutropenia.
Conclusion: There are few analyses in Mexico about real chemotherapy regimens in BT and STS. The overall
survival in the Mexican population is lower than the internationally reported one, thus justify prospective
studies to identify challenges and improve it.