• Renée L Mulder, Marios Paulides, Thorsten Langer, Leontien C M Kremer, and Elvira C van Dalen.
• Department of Paediatric Oncology, Emma Children’s Hospital / Academic Medical Center, Amsterdam, Netherlands. r.l.mulder@amc.uva.nl.
• Cochrane Db Syst Rev. 2012 Dec 12; 12: CD006300.

BackgroundAlkylating 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. This is an update of the first systematic review evaluating the state of evidence on the effectiveness of cyclophosphamide as compared to ifosfamide for paediatric and young adult patients with sarcoma.ObjectivesTo compare the possible effectiveness of cyclophosphamide with that of ifosfamide for paediatric and young adult patients with sarcoma.Search MethodsWe searched CENTRAL (The Cochrane Library 2012, issue 2), MEDLINE/PubMed (from 1966 to March 2012) and EMBASE/Ovid (from 1980 to March 2012) with pre-specified terms. In addition, we searched reference lists of relevant articles, conference proceedings and ongoing trial databases (www.controlled-trials.com; searched April 2012).Selection CriteriaRandomised 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.Data Collection And AnalysisTwo authors independently performed the study selection.Main ResultsNo studies meeting the inclusion criteria of the review were identified.Authors' ConclusionsNo 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.

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