Cyclophosphamide versus ifosfamide for paediatric and young adult bone and soft tissue sarcoma patients.

Alkylating agents, such as cyclophosphamide and ifosfamide, play a major role in the improved survival of children and young adults with bone and soft tissue sarcoma. However, there is still controversy as to their comparative anti-tumour efficacy and possible adverse effects. To compare the possible effectiveness of cyclophosphamide with that of ifosfamide for paediatric and young adult patients with sarcoma. We searched CENTRAL (The Cochrane Library 2008, issue 4), MEDLINE/PubMed (from 1966 to November 2008) and EMBASE/Ovid (from 1980 to November 2008) with pre-specified terms. In addition, we searched reference lists of relevant articles, conference proceedings and ongoing trial databases. Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) comparing cyclophosphamide and ifosfamide for the treatment of different types of sarcoma in paediatric and young adult patients (aged less than 30 years at diagnosis). Chemotherapy other than either cyclophosphamide or ifosfamide should have been the same in both treatment groups. Two authors independently performed the study selection. No studies meeting the inclusion criteria of the review were identified. No RCTs or CCTs comparing the effectiveness of cyclophosphamide and ifosfamide in the treatment of bone and soft tissue sarcoma in children and young adults were identified. Therefore no definitive conclusions can be made about the effects of cyclophosphamide and ifosfamide in these patients. Based on the currently available evidence we are not able to give recommendations for clinical practice. More high quality research is needed.