Related Experiment Videos
Megatherapy in children with high-risk Ewing's sarcoma in first complete remission
L Madero1, A Muñoz, J Sánchez de Toledo
1Department of Pediatric Hematology, Hospital Infantil Niño Jesús, Autonomous University of Madrid, Spain.
Insights
High-risk Ewing's sarcoma patients showed improved outcomes with megatherapy and hematopoietic rescue. This intensive treatment offers better survival rates for metastatic or localized disease compared to conventional therapies.
Area of Science:
- Pediatric Oncology
- Hematology
- Cancer Therapeutics
Background:
- Ewing's sarcoma is a high-risk bone cancer in children.
- Improving prognosis for metastatic or high-risk localized sarcoma in first complete remission (CR) is crucial.
- Consolidation therapy is being explored to enhance treatment efficacy.
Purpose of the Study:
- To evaluate the role of megatherapy and hematopoietic rescue as consolidation therapy.
- To assess the impact of this intensive treatment on disease-free survival in high-risk Ewing's sarcoma patients.
- To compare outcomes with conventional treatment approaches.
Main Methods:
- Retrospective analysis of 72 Ewing's sarcoma patients (1986-1995) from three pediatric centers.
- Identification of 30 high-risk patients, with 20 receiving megatherapy and hematopoietic rescue.
- Analysis of prognostic factors including metastatic disease, tumor volume, and pelvic location.
Main Results:
- Overall disease-free survival was 62.7%+/-11% for patients receiving megatherapy.
- Survival rates varied by disease characteristics: 40%+/-21.9% for metastatic disease, 76.2%+/-12.2% for large tumors (>100 ml), and 64.8%+/-16.5% for pelvic tumors.
- Megatherapy demonstrated improved outcomes compared to expected results from conventional therapy.
Conclusions:
- Megatherapy combined with hematopoietic rescue appears to improve outcomes for high-risk Ewing's sarcoma patients.
- This intensive consolidation strategy warrants consideration for selected patient groups.
- Further research may refine patient selection and treatment protocols.
Abstract:
To improve the prognosis of patients with metastatic or high-risk localized sarcoma in first CR, we explored the role of consolidation therapy with megatherapy and hematopoietic rescue. From 1986 to 1995, of 72 patients with Ewing's sarcoma from three pediatric departments, 30 were diagnosed as high-risk patients. Of these 30 patients, six did not achieve complete remission and four refused megatherapy and received multimodal treatment (chemotherapy + surgery and/or radiotherapy). The remaining 20 patients received megatherapy. There were 15 males and five females with a median age of 10.8 years (range 2-18 years). Five patients had metastatic disease at initial diagnosis, nine patients had primary tumor in the pelvis and 13 had a tumor volume greater than 100 ml. Overall disease-free survival was 62.7+/-11%; 40+/-21.9% for those with metastatic disease, 76.2+/-12.2% for those with tumor volume greater than 100 ml and 64.8+/-16.5% for those with tumor in pelvic bones. In conclusion, megatherapy has improved the outcome of this group of patients relative to that expected following conventional therapy.