Why the study?
Does the type of local treatment and chemotherapy protocol affect survival and recurrence in patients with Ewing's sarcoma of the femur?
Does the type of local treatment and chemotherapy protocol affect survival and recurrence in patients with Ewing's sarcoma of the femur?
In patients with Ewing's sarcoma of the femur, surgery with or without radiotherapy provides better survival than radiotherapy alone, and newer chemotherapy protocols improved 10-year relapse-free survival.
May support surgery ± radiotherapy over radiotherapy alone in femoral Ewing sarcoma; leaves open optimal chemotherapy protocols for prospective trials.
We reviewed the treatment outcome of 69 patients with Ewing's sarcoma of the femur. The patients received chemotherapy according to the CESS 81 (n 14), CESS 86 (n 43), and CESS 91P (n 12) protocols. The 10-year relapse-free survival rates were 36%, 65%, and 65% (p = 0.01). 68 patients received local treatment. The primary tumor was treated by surgery without radiotherapy in 28 patients; 1 developed a local recurrence and 7 metastases. 10 patients received radiotherapy alone; 4 developed metastases and 4 local recurrences and metastases. 30 cases had a combination of surgery and radiotherapy; 7 developed metastases and 1 a local recurrence and metastasis. The survival of patients after radiotherapy alone was worse than that of patients after surgery with/without radiotherapy (p = 0.005). Pathological fractures (n 16) did not influence the prognosis.
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Ozaki et al. (1997) studied this question.
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