Past failures and future possibilities in Ewing's sarcoma:Experimental and preliminary clinical results

The typical clinical course of Ewing's sarcoma is characterized by the rapid development of generalized disease. The probability of subclinical metastases in the majority of patients at the time of diagnosis indicates the need for systemic therapy as an integral part of primary treatment. Studies are described with a laboratory model system which experimentally parallels the clinical situation by using a locally transplanted tumor which rapidly metastasizes. A combination of local irradiation and systemic chemotherapy on the experimental mice provided some long-term survivors free of disease, whereas neither treatment alone was successful. A preliminary clinical trial on patients with Ewing's sarcoma treated with a similar combined approach has resulted in two survivors free of disease at 52 and 44 months out of three patients so treated.