BACKGROUND: Attempts to improve survival outcomes of patients with high risk Ewing's sarcoma (ES) have focused on chemotherapy dose intensification strategies. AIM: The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. MATERIALS AND METHODS: From 1995 to 2008, seventeen patients (male:female, 14:3) were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2-15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N = 5) received busulfan/melphalan. RESULTS: Median follow-up was 78 months (range: 15-155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2- and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. CONCLUSION: This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe.
BACKGROUND: Attempts to improve survival outcomes of patients with high risk Ewing's sarcoma (ES) have focused on chemotherapy dose intensification strategies. AIM: The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. MATERIALS AND METHODS: From 1995 to 2008, seventeen patients (male:female, 14:3) were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2-15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N = 5) received busulfan/melphalan. RESULTS: Median follow-up was 78 months (range: 15-155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2- and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. CONCLUSION: This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: L H Wexler; T F DeLaney; M Tsokos; N Avila; S M Steinberg; L Weaver-McClure; J Jacobson; P Jarosinski; Y M Hijazi; F M Balis; M E Horowitz Journal: Cancer Date: 1996-08-15 Impact factor: 6.860
Authors: P A Meyers; M D Krailo; M Ladanyi; K W Chan; S L Sailer; P S Dickman; D L Baker; J H Davis; R B Gerbing; A Grovas; C E Herzog; K L Lindsley; W Liu-Mares; J B Nachman; L Sieger; J Wadman; R G Gorlick Journal: J Clin Oncol Date: 2001-06-01 Impact factor: 44.544
Authors: James S Miser; Mark D Krailo; Nancy J Tarbell; Michael P Link; Christopher J H Fryer; Douglas J Pritchard; Mark C Gebhardt; Paul S Dickman; Elizabeth J Perlman; Paul A Meyers; Sarah S Donaldson; Sheila Moore; Aaron R Rausen; Teresa J Vietti; Holcolmbe E Grier Journal: J Clin Oncol Date: 2004-07-15 Impact factor: 44.544
Authors: Lianne M Haveman; Roelof van Ewijk; Elvira C van Dalen; Willemijn B Breunis; Leontien Cm Kremer; Henk van den Berg; Uta Dirksen; Johannes Hm Merks Journal: Cochrane Database Syst Rev Date: 2021-09-02