Current trends in the treatment of Ewing's sarcoma

The authors analyse the results obtained in the treatment of Ewing's sarcoma by comparing the period previous to the use of chemotherapy with the more recent one involving the use of antiblastic drugs. Thirty-one patients with Ewing's sarcoma were divided into three groups according to the type of treatment used. The first group included 11 patients treated either by surgery or high dosage radiation (7000-8000 rads); the second group included 9 patients treated by radiation plus polychemotherapy; finally, the third group included 11 patients treated by surgery (excision in 5 localizations and segmental resection in the remaining 6), associated with polychemotherapy and low dosage radiotherapy. The results in the first group were discouraging as none of the patients survived five years; there was a low survival rate (33%) for the second group, partly due to the fact that there were 4 localizations in the pelvis, a site with a notoriously unfavourable prognosis; the third group had the highest percentage (55%) of long-term disease-free patients. Thus, in agreement with what is reported in the literature, the most radical surgery possible, associated with polychemotherapy and low-dose radiotherapy, currently seems to be the best treatment.