Why the study?
Does the SSG IX protocol improve survival and local control compared to the SSG IV protocol in patients with Ewing's sarcoma?
Does the SSG IX protocol improve survival and local control compared to the SSG IV protocol in patients with Ewing's sarcoma?
The SSG IX protocol, utilizing ifosfamide and cisplatin with earlier local therapy, improved local control and survival rates compared to the older SSG IV protocol in patients with Ewing's sarcoma.
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SSG IX was associated with better survival and local control in Ewing sarcoma; hypothesis-generating and requires randomized confirmation before practice change.
During the past 15 years the Scandinavian Sarcoma Group has treated 140 patients with Ewing's sarcoma. Two protocols have been used. SSG IV included 52 patients between 1984 and 1990 and SSG IX, 88 patients since 1990. After 5 years of treatment, local recurrences occurred in 19% of the patients (M0 + M1) in the SSG IV group and 10% in the SSG IX group. Distant metastases developed in 57% of the M0-patients in the SSG IV group and in 33% in the SSG IX group. Tumor-related survival (overall) of M0-patients was 49% in SSG IV and 70% in SSG IX, and the metastasis-free survival rate 45% and 58%, respectively. Patients having a localized extremity tumor had a survival rate of 90% (SSG IX). In both treatment groups, good responders to chemotherapy had a better survival rate than poor ones (SSG IV, p < 0.02, GI-II vs. G II-IV and SSG IX, p < 0.003, GI-III vs. G IV). In conclusions local control and survival rates were better with SSG IX than SSG IV.
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Smeland et al. (2004) studied this question.
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