[Treatment of Ewing's sarcoma with 2 different protocols]

Area of Science:

• Oncology
• Orthopedic Oncology
• Pediatric Oncology

Background:

• Ewing's sarcoma of bone is a rare bone cancer primarily affecting children and young adults.
• Treatment for localized Ewing's sarcoma has evolved, with chemotherapy and local control strategies playing crucial roles.
• Optimizing treatment protocols is essential to improve survival rates and reduce metastatic disease.

Purpose of the Study:

• To evaluate the impact of a six-drug chemotherapy regimen compared to a standard four-drug regimen in localized Ewing's sarcoma.
• To assess the effectiveness of different local treatment modalities (radiotherapy, surgery) on patient outcomes.
• To identify prognostic factors influencing disease-free survival in patients with localized Ewing's sarcoma.

Main Methods:

• Retrospective analysis of 54 patients with localized Ewing's sarcoma treated between 1985 and present.
• Comparison of outcomes between patients receiving a four-drug (doxorubicin, dactinomycin, vincristine, cyclophosphamide) and a six-drug (adding cisplatin, ifosfamide) chemotherapy protocol.
• Analysis of local treatment strategies including radiotherapy alone, postoperative radiotherapy, and surgery alone.

Main Results:

• The six-drug chemotherapy protocol demonstrated a significantly higher 5-year disease-free survival rate (61%) compared to the four-drug protocol (23%).
• Surgery as a local treatment also showed improved 5-year disease-free survival (61%) compared to radiotherapy-based treatments (25%).
• Pelvic tumor localization and large tumor volume were identified as negative prognostic factors.

Conclusions:

• The addition of cisplatin and ifosfamide to standard chemotherapy significantly enhances disease-free survival in localized Ewing's sarcoma.
• Surgical intervention as local treatment is associated with superior outcomes compared to radiotherapy.
• Treatment strategies should consider tumor location and volume to optimize patient prognosis.