open access

Vol 16, No 5 (2011)
Reviews
Published online: 2011-09-01
Submitted: 2010-09-28
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Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

Jose Luis Lopez, Concepcion Pérez, Catalina Marquez, Patricia Cabrera, Jose Maria Perez, Gema Lucia Ramirez, Rafael Ordoñez, Juan Manuel Praena-Fernandez, Maria Jose Ortiz
DOI: 10.1016/j.rpor.2011.04.002
·
Rep Pract Oncol Radiother 2011;16(5):163-169.

open access

Vol 16, No 5 (2011)
Reviews
Published online: 2011-09-01
Submitted: 2010-09-28

Abstract

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[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]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.

Abstract

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[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]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.

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Keywords

Ewing' s sarcoma; Myeloablative therapy; Outcome

About this article
Title

Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 16, No 5 (2011)

Pages

163-169

Published online

2011-09-01

DOI

10.1016/j.rpor.2011.04.002

Bibliographic record

Rep Pract Oncol Radiother 2011;16(5):163-169.

Keywords

Ewing's sarcoma
Myeloablative therapy
Outcome

Authors

Jose Luis Lopez
Concepcion Pérez
Catalina Marquez
Patricia Cabrera
Jose Maria Perez
Gema Lucia Ramirez
Rafael Ordoñez
Juan Manuel Praena-Fernandez
Maria Jose Ortiz

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