Long-Term Event-Free Survival After Intensive Chemotherapy for Ewing’s Family of Tumors in Children and Young Adults

Author:

Kolb E. Anders1,Kushner Brian H.1,Gorlick Richard1,Laverdiere Caroline1,Healey John H.1,LaQuaglia Michael P.1,Huvos Andrew G.1,Qin Jing1,Vu Ha Thanh1,Wexler Leonard1,Wolden Suzanne1,Meyers Paul A.1

Affiliation:

1. From the Departments of Pediatrics, Surgery, Pathology, Biostatistics, and Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.

Abstract

Purpose: To improve the long-term event-free survival of patients with Ewing’s family of tumors (EFTs) using high-dose, short-term chemotherapy. Patients and Methods: P6 was a prospective study of previously untreated patients with newly diagnosed EFTs. Patients received seven cycles of chemotherapy. Cycles 1, 2, 3, and 6 consisted of cyclophosphamide 2,100 mg/m2/d on days 1 and 2, and a 72-hour continuous infusion of doxorubicin 75 mg/m2 and vincristine 2 mg/m2 starting day 1. Cycles 4, 5, and 7 consisted of 5 consecutive days of ifosfamide 1,800 mg/m2/d and etoposide 100 mg/m2/d. Results: Sixty-eight patients were enrolled from 1991 to 2001 (median age, 18.7 years; range, 3.7 to 39.9 years). At diagnosis, 44 patients had local-regional disease, and 24 had distant metastases. The 4-year event-free survival (EFS) rate for patients with local-regional disease is 82%; overall survival (OS) is 89%. The 4-year EFS rate for patients with distant metastases is 12%; the OS rate is 17.8%. All events occurred within 51 months of diagnosis. Four patients with distant metastases had progressive disease during therapy, and no patient with local-regional disease experienced disease progression during therapy. Conclusion: Sustained EFS and OS can be achieved with intensive chemotherapy in children and young adults with local-regional EFTs. This therapy is relatively ineffective in the treatment of metastatic EFTs.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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