[Ewing's sarcoma in childhood: the therapeutic results]

We evaluated 27 patients with localized Ewing's sarcoma diagnosed in our hospital. In 9 cases the lesion was centroaxial and in 18 it was located in the limbs. The treatment consisted of: 1) chemotherapy with 6 drugs (vincristine, cyclophosphamide, methotrexate, bleomycin, actinomycin D and adriamycin) during one year in all patients, and 2) radiotherapy in 24 patients with a dose of 30-40 Gy in the involved bone with a 10-15 Gy superimpression on the tumor area. In 7 patients nonradical surgery followed by radiotherapy was carried out. In 2 cases with rib localization and in 1 with tibial localization and large bone destruction radical surgery was undertaken. One patient had a local relapse (femur) and six had distant metastases. The remaining 20 patients (74%) are alive and without evidence of disease, with follow-up periods ranging from 17 to 80 months (median 38 months). The estimated actuarial free from disease survival was 64% after 58 months. Sequelae of therapy were evaluated in the 12 survivors with primary localization in the limbs. In 7 cases (58%) there were minimal sequelae, in two moderate and in three there was a severe limitation, but amputation was not required in any patient. The results of our study show that the local control of the disease can be achieved in most cases without radical surgery and with an acceptable limb function.