[Interdisciplinary therapy of Ewing sarcoma]

Ewing's sarcoma is the most common bone tumor in children under ten years of age. It represents a highly malignant tumor that usually arises in bone, but occasionally occurs in soft tissues. Most patients with Ewing's sarcoma present with what appears to be localized disease, but surgery and radiotherapy alone is unlikely to be curative due to the presence of micrometastases. Consequently chemotherapy has become increasingly effective in eliminating these cells, as well as assisting in obtaining local control. The goal of the optimal integration of the three modalities of therapy is to eradicate all tumor while preserving as much function as possible. The extent of the disease determines the aggressiveness of treatment. Diagnostic evaluation includes modern radiologic imaging, immunochemical and cytogenetic techniques. The outlook has dramatically changed in case of nonmetastatic disease, achieving local control of the tumor in 80%, and producing 5-year disease-free survival in two thirds of the patients.