Why the study?
Does cyclophosphamide and doxorubicin induction therapy followed by delayed surgery, RT, and maintenance chemotherapy induce remission and improve survival in patients with previously untreated metastatic Ewing's sarcoma?
Does cyclophosphamide and doxorubicin induction therapy followed by delayed surgery, RT, and maintenance chemotherapy induce remission and improve survival in patients with previously untreated metastatic Ewing's sarcoma?
A protocol of induction chemotherapy, delayed surgery, and radiation therapy can achieve long-term disease-free survival in patients with metastatic Ewing's sarcoma.
May support this approach in metastatic Ewing sarcoma; leaves open confirmation in prospective trials.
Eighteen patients with previously untreated metastatic Ewing's sarcoma (ES) entered a protocol designed to evaluate the response rate to cyclophosphamide and doxorubicin induction therapy delivered before delayed surgery and delayed lower dose, limited-field radiation therapy, (RT), and maintenance chemotherapy. With chemotherapy and delayed surgery, 14 of 18 were rendered free of gross tumor. RT was delivered to the primary site of 11 of these responding patients, plus four of those not free of gross disease. Following RT, two more attained complete clinical remission. Site of primary or metastases did not influence outcome; however, the size of the primary at diagnosis did appear to do so. Ten patients remain disease-free 16 to 82 months (median, 47 months) from diagnosis.
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Hayes et al. (1987) studied this question.
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