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Oncol Rep. 1997 Sep-Oct;4(5):977-85. doi: 10.3892/or.4.5.977.

Long-term follow-up for patients with Ewing's sarcoma of bone treated with adjuvant and neoadjuvant chemotherapy.

Oncology reports

G Bacci, S Ferrari, E Barbieri, A Longhi, C Forni, M Cesari, M Sarti, A Gasbarrini, P Rosito, A Delprever

Affiliations

  1. IST RIZZOLI,SEZ CHEMIOTERAPIA,LAB ONCOL,BOLOGNA,ITALY. IST RIZZOLI,DIV CHIRURG ORTOPED,BOLOGNA,ITALY. UNIV BOLOGNA,IST RADIO,BOLOGNA,ITALY. UNIV BOLOGNA,TERZA CLIN PEDIAT,BOLOGNA,ITALY. UNIV TURIN,DIV PEDIAT ONCOL,TURIN,ITALY.

PMID: 21590179 DOI: 10.3892/or.4.5.977

Abstract

The long-term results obtained in 252 patients with non-metastatic Ewing's sarcoma of bone treated between March 1972 and June 1988 according to three sequential protocols of treatment were evaluated. Primary tumor was treated with radiotherapy in 125 cases, with surgery in 52 and with surgical resection followed by radiotherapy in 75. In the first protocol (REA 1; 1972-78) chemotherapy was performed with a 3-drug regimen (VCR, CPM, ADM), whereas in the REA 2 protocol (1979-82) and in the REN 1 protocol (1983-88) a 4-drug regimen was used (VCR, CPM, ADM, ACTD). Chemotherapy was delivered as adjuvant treatment in REA 1 and 2, and as neoadjuvant in the last study. At a mean follow-up of 14.8 years, with the 95% of patients with a minimum FU of 10 years, 101 pts (40%) remained continuously free of disease, 144 patients relapsed, two patients died of adriamycin cardiotoxicity and 5 patients developed a second neoplasm. 6% of the patients relapsed 5 or more years after the diagnosis with the latest recurrence registered at the tenth year. Type of local treatment, LDH serum level, chemotherapy protocol and sex were predictive factors of DFS after a multivariate analysis. The possibility of late relapse in Ewing's sarcoma has been confirmed by our retrospective study and for patients with Ewing's sarcoma, a 10-year follow up should be recommended.

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