Annals of Oncology 14:1654-1659, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Therapy and survival after recurrence of Ewing’s tumors: the Rizzoli experience in 195 patients treated with adjuvant and neoadjuvant chemotherapy from 1979 to 1997
1 Department of Chemotherapy, 2 Department of Thoracic Surgery, Istituto Ortopedico Rizzoli, Bologna; 3 Department of Radiotherapy, Policlinico S.Orsola/Malpighi, Bologna, Italy
Received 12 March 2003; revised 14 April 2003; accepted 11 August 2003
Background:
Many papers have reported the results achieved with combined therapy for Ewing’s tumors, but little is known about the treatment and outcome of those 30–40% of patients who relapse.
Patients and methods:
In a retrospective study, we evaluated 195 patients with Ewing’s tumors treated at our institution from 1979 to 1997 with chemotherapy, radiotherapy, surgery or combined therapies after recurrence.
Results:
A second complete remission was achieved in only 26 patients (13.3%); 12 relapsed again and died of the tumor. The 5-year post-relapse event-free survival and overall survival were 9.7% and 13.8%, respectively; both of which were significantly better for patients who had relapsed 
2 years after the beginning of the first treatment (14.3% versus 2.5%; P <0.001) and for patients who relapsed with only lung metastases (14.5% versus 0.9%; P <0.0005). In terms of treatment, patients treated with surgery or radiotherapy, alone or in combination with chemotherapy, had better survival rates than patients treated with chemotherapy alone (15.4% versus 0.9%; P <0.0001).
Conclusions:
The outcome of Ewing’s tumor patients who relapse after combined treatment is very poor. However, these patients may be divided into two groups: those that can be cured with traditional treatments (late relapse and/or only lung metastases), and a second group of patients (early relapses with metastases in lungs and/or other sites) who gain no benefit from traditional therapies. For the latter group, multicenter studies are needed to evaluate new strategies of treatment.
Key words: Ewing’s sarcoma, outcome, relapse, treatment
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K. Scotlandi, D. Remondini, G. Castellani, M. C. Manara, F. Nardi, L. Cantiani, M. Francesconi, M. Mercuri, A. M. Caccuri, M. Serra, et al. Overcoming Resistance to Conventional Drugs in Ewing Sarcoma and Identification of Molecular Predictors of Outcome J. Clin. Oncol., May 1, 2009; 27(13): 2209 - 2216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Miller, L. Emerson, F. Clayton, B. G. Bentz, R. E. Data, K. L. Salzman, L. M. Smith, and M. K. Yu Extraosseous Ewing's Sarcoma J. Clin. Oncol., October 20, 2007; 25(30): 4845 - 4848. [Full Text] [PDF]
|
|
|
|
 |
|
 P. T. Liu, S. D. Valadez, F. S. Chivers, C. C. Roberts, and C. P. Beauchamp Anatomically Based Guidelines for Core Needle Biopsy of Bone Tumors: Implications for Limb-sparing Surgery RadioGraphics, January 1, 2007; 27(1): 189 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. McTiernan, D. Driver, M. P. Michelagnoli, A. M. Kilby, and J. S. Whelan High dose chemotherapy with bone marrow or peripheral stem cell rescue is an effective treatment option for patients with relapsed or progressive Ewing's sarcoma family of tumours Ann. Onc., August 1, 2006; 17(8): 1301 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Barker, T. W. Pendergrass, J. E. Sanders, and D. S. Hawkins Survival After Recurrence of Ewing's Sarcoma Family of Tumors J. Clin. Oncol., July 1, 2005; 23(19): 4354 - 4362. [Abstract] [Full Text] [PDF]
|
|