Treatment of femoral Ewing's sarcoma Journal Article
| Authors: | Terek, R. M.; Brien, E. W.; Marcove, R. C.; Meyers, P. A.; Lane, J. M.; Healey, J. H. |
| Article Title: | Treatment of femoral Ewing's sarcoma |
| Abstract: | BACKGROUND. The treatment of Ewing's sarcoma consists of chemotherapy for systemic and local disease. However, the role of radiation therapy, and/or surgical resection for definitive local treatment has yet to be determined. METHODS. A retrospective review of 32 patients (24 males and 8 females) treated for femoral Ewing's sarcoma between 1970 and 1985 was performed. Patients were divided into 3 treatment groups: chemotherapy and radiotherapy (CR) (10); chemotherapy and surgery (CS) (9); and chemotherapy, surgery, and radiotherapy (CSR) (13). Patients in the CR group received a mean of 5320 centigray (cGy) of radiation anti patients in the CSR group received a mean of 3590 cGy. Multiagent cyclophosphamide/doxorubicin based chemotherapy was used in all cases. Surgery consisted of wide resection or amputation. RESULTS. Patients in the CR group had a higher risk of local recurrence than patients in the CS and CSR groups (P = 0.02, log rank). The combination of local recurrences and treatment complications necessitated surgery for 7 of 10 CR patients, whereas 1 of 9 and 4 of 13 in the CS and CSR groups required additional surgery. The median survival for the entire group was 39 months. Minimum follow-up for surviving patients was 45 months. Five year survival consisted of 1 of 10 patients in the CR group, 2 of 9 in the CS group, and 7 of 13 in the CSR group. There were no statistically significant differences among the three survival curves. Tumor location within the femur was a significant prognostic variable. Distal femoral location had a survival advantage compared with proximal and mid-femur locations (P = 0.049, log rank). CONCLUSIONS. Femoral Ewing's sarcoma remains a disease with a poor prognosis. Radiation alone for local treatment results in a high rate of local recurrence and complications. Our current local treatment strategy for femoral Ewing's sarcoma includes surgery in all and adjuvant radiotherapy in many of the patients. |
| Keywords: | adolescent; adult; cancer survival; child; clinical article; child, preschool; survival analysis; bone tumor; retrospective studies; cancer recurrence; salvage therapy; doxorubicin; cancer combination chemotherapy; patient selection; chemotherapy, adjuvant; radiotherapy, adjuvant; chemotherapy; follow up; neoplasm recurrence, local; tumor markers, biological; cyclophosphamide; retrospective study; ewing sarcoma; statistical analysis; surgery; radiation therapy; sarcoma, ewing's; l-lactate dehydrogenase; femoral neoplasms; humans; human; male; female; priority journal; article |
| Journal Title: | Cancer |
| Volume: | 78 |
| Issue: | 1 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1996-07-01 |
| Start Page: | 70 |
| End Page: | 78 |
| Language: | English |
| DOI: | 10.1002/(sici)1097-0142(19960701)78:1<70::aid-cncr12>3.0.co;2-4 |
| PUBMED: | 8646729 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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