TY - JOUR
T1 - Nonmetastatic Ewing family tumors
T2 - High-dose chemotherapy with stem cell rescue in poor responder patients. results of the Italian Sarcoma Group/Scandinavian Sarcoma Group III protocol
AU - Ferrari, S.
AU - Hall, K. Sundby
AU - Luksch, R.
AU - Tienghi, A.
AU - Wiebe, T.
AU - Fagioli, F.
AU - Alvegard, T. A.
AU - del Prever, A. Brach
AU - Tamburini, A.
AU - Alberghini, M.
AU - Gandola, L.
AU - Mercuri, M.
AU - Capanna, R.
AU - Mapelli, S.
AU - Prete, A.
AU - Carli, M.
AU - Picci, P.
AU - Barbieri, E.
AU - Bacci, G.
AU - Smeland, S.
PY - 2011
Y1 - 2011
N2 - Background: High-dose chemotherapy (HDT) was added to conventional chemotherapy in Ewing sarcoma family tumor (EFT) patients, poor responders (PRs) to induction chemotherapy in order to improve their survival. Patients and methods: Patients aged ≤40 years with nonmetastatic Ewing sarcoma (ES) received vincristine (V), doxorubicin (A), cyclofosfamide (C), actinomycin (Ac), ifosfamide (I) and etoposide (E) (VACAc-IE regimen) as induction chemotherapy. As maintenance treatment, good responders (GR) received nine cycles of VACAc-IE regimen. PRs received three cycles of VAC-IE, mobilizing cycle with CE and HDT with Busulfan and Melphalan with stem cell support. Results: Three hundred patients [median age 15 years (3-40 years)] entered the study. One patient refused local treatment, 242 (81%) underwent surgery [with radiotherapy (RT) in 80] and 57 (19%) RT alone. No toxic deaths were recorded. Overall GR were 146 (49%). Twenty-eight PR did not receive HDT. At a median follow-up of 64 months (21-116 months), 5-year overall and event-free survival (EFS) were 75% and 69%, respectively. Five-year EFS was 75% for GR, 72% for PR treated with HDT and 33% for PR who did not receive HDT. Conclusions: High-dose therapy added to the VACA-IE regimen in PR patients is feasible and effective. Selected groups of patients with ES can benefit from HDT.
AB - Background: High-dose chemotherapy (HDT) was added to conventional chemotherapy in Ewing sarcoma family tumor (EFT) patients, poor responders (PRs) to induction chemotherapy in order to improve their survival. Patients and methods: Patients aged ≤40 years with nonmetastatic Ewing sarcoma (ES) received vincristine (V), doxorubicin (A), cyclofosfamide (C), actinomycin (Ac), ifosfamide (I) and etoposide (E) (VACAc-IE regimen) as induction chemotherapy. As maintenance treatment, good responders (GR) received nine cycles of VACAc-IE regimen. PRs received three cycles of VAC-IE, mobilizing cycle with CE and HDT with Busulfan and Melphalan with stem cell support. Results: Three hundred patients [median age 15 years (3-40 years)] entered the study. One patient refused local treatment, 242 (81%) underwent surgery [with radiotherapy (RT) in 80] and 57 (19%) RT alone. No toxic deaths were recorded. Overall GR were 146 (49%). Twenty-eight PR did not receive HDT. At a median follow-up of 64 months (21-116 months), 5-year overall and event-free survival (EFS) were 75% and 69%, respectively. Five-year EFS was 75% for GR, 72% for PR treated with HDT and 33% for PR who did not receive HDT. Conclusions: High-dose therapy added to the VACA-IE regimen in PR patients is feasible and effective. Selected groups of patients with ES can benefit from HDT.
KW - Chemotherapy-induced necrosis
KW - Ewing sarcoma
KW - High-dose chemotherapy
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U2 - 10.1093/annonc/mdq573
DO - 10.1093/annonc/mdq573
M3 - Article
C2 - 21059639
AN - SCOPUS:79955502856
SN - 0923-7534
VL - 22
SP - 1221
EP - 1227
JO - Annals of Oncology
JF - Annals of Oncology
IS - 5
ER -