Synovial sarcoma are a heterogeneous group of malignant bone tumors. Doxorubicin, cisplatin, high-dose methotrexate and ifosfamide have antitumor activity in osteosarcoma, a similar type of cancer. Doxorubicin and cisplatin are frequently used as the basis of treatment, and there is evidence that combinations with methotrexate and/or ifosfamide might provide additional benefit over two-drug schedules. A variety of pre- and postoperative combinations are used in common practice and in clinical trials, and the ideal combination scheme and the optimal treatment duration are yet to be defined.NCCN does not present any chemo options for synovial sarcoma.
Ifosfamide based chemotherapy is associated with improved survival of synovial sarcoma (Eber et al). Chen reported that first line MAID or AIM, second line Gemcitabine + Docetaxel with sufficient dose intensity in patients with stage IIB/III synovial sarcoma produced benefit( in DSS-disease specific survival, MFS, and a prolonged TTM).
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Fritz C. Eilber et al, Chemotherapy Is Associated With Improved Survival in Adult Patients With Primary Extremity Synovial Sarcoma Ann Surg. 2007 July; 246(1): 105–113.
Canter RJ, Qin LX, Maki RG, Brennan MF, Ladanyi M, Singer S. A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients.Clin Cancer Res. 2008 Dec 15;14(24):8191-7.
Adjuvant chemotherapy decreases and postpones distant metastasis in extremity stage IIB/III synovial sarcoma patients, Yong Chen MD, Yun Yang MD3, Chunmeng Wang, Yingqiang Shi MD J Surg Oncol, 1 FEB 2012 DOI: 10.1002/jso.23061