Key result
The addition of ifosfamide and dactinomycin to a conventional VAC regimen achieved a higher rate of good histological responses in patients with Ewing's sarcoma.
Why the study?
Does the addition of ifosfamide and dactinomycin to a VAC regimen improve histological response in patients with Ewing's sarcoma?
Cohort (n=243)
Does the addition of ifosfamide and dactinomycin to a VAC regimen improve histological response in patients with Ewing's sarcoma?
The addition of ifosfamide and dactinomycin to a conventional VAC regimen improves histological response in Ewing's sarcoma, which is a reliable predictor of event-free survival.
May support intensified VAC in Ewing sarcoma; leaves open survival impact pending randomized confirmation.
Clinicopathologic variables associated with a good histological response to primary chemotherapy in Ewing's sarcoma are identified. The histological response to preoperative chemotherapy in 243 cases of Ewing's sarcoma treated with neoadjuvant chemotherapy was analyzed in relation to different clinicopathological features (sex and age of the patients, tumor size, serum lactate dehydrogenase (LDH) levels, tumor site) and to the type and schedule of anticancer drugs delivered preoperatively according to three consecutive chemotherapy regimens. A higher rate of good responses was achieved with the use of ifosfamide and dactinomycin in addition to a conventional three-drug VAC regimen, suggesting that these drugs should be included from the beginning in neoadjuvant regimens for the treatment of Ewing's sarcoma. The analysis of event-free survival in 158 patients with a 4-year minimum follow-up confirmed that histological response to preoperative chemotherapy is a reliable predictor of outcome in Ewing's sarcoma.
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Bacci et al. (1998) conducted a cohort in Ewing's sarcoma (n=243). Ifosfamide and dactinomycin added to a conventional three-drug VAC regimen vs. Conventional three-drug VAC regimen was evaluated on Histological response to primary chemotherapy. The addition of ifosfamide and dactinomycin to a conventional VAC regimen achieved a higher rate of good histological responses in patients with Ewing's sarcoma.
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