Treatment strategies for metastatic Ewing's sarcoma

Citation
Cr. Pinkerton et al., Treatment strategies for metastatic Ewing's sarcoma, EUR J CANC, 37(11), 2001, pp. 1338-1344
Citations number
23
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
EUROPEAN JOURNAL OF CANCER
ISSN journal
0959-8049 → ACNP
Volume
37
Issue
11
Year of publication
2001
Pages
1338 - 1344
Database
ISI
SICI code
0959-8049(200107)37:11<1338:TSFMES>2.0.ZU;2-5
Abstract
Therapy in metastatic Ewing's sarcoma is reviewed using the methodology rec ommended by the guidelines project of the Federation. of French Cancer Cent res (FNCLCC) Standards, Options and Recommendation (SOR) Group. Twelve arti cles relating to conventional dose therapy and seven articles related to hi gh-dose therapy were judged suitable for detailed appraisal. Rates of compl ete response (CR) at metastatic sites and local control were high using com binations of vincristine, actinomycin, cyclophosphamide and doxorubicin wit h radiation or surgery. With more recent regimens, including increased dose s of alkylating agents and anthracyclines the relapse-free survival has inc reased from < 15 to 20-30%. 'Megatherapy' regimens with haematopoietic stem cell rescue are tolerable in this patient group, but to date there is litt le evidence of any benefit. It appears that patients with isolated lung met astases do significantly better (approximately 40% EFS) than those presenti ng with combined sites such as bone, bone marrow and lung. The use of lung irradiation in children with lung metastases is associated with a reduced i ncidence of subsequent lung recurrence and a consistently better overall re lapse-free survival (RFS). (C) 2001 Elsevier Science Ltd. All rights reserv ed.