| Title | Local control in pelvic Ewing sarcoma: analysis from INT-0091--a report from the Children's Oncology Group. | | Author(s) | Yock TI, Krailo M, Fryer CJ, Donaldson SS, Miser JS, Chen Z, Bernstein M, Laurie F, Gebhardt MC, Grier HE, Tarbell NJ, Children's Oncology Group | | Institution | Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA. TYOCK@PARTNERS.ORG | | Source | J Clin Oncol 2006 Aug 20; 24(24):3838-43. | | MeSH | Antineoplastic Combined Chemotherapy Protocols
Bone Neoplasms
Chemotherapy, Adjuvant
Child
Child, Preschool
Confounding Factors (Epidemiology)
Cyclophosphamide
Dactinomycin
Disease Progression
Doxorubicin
Etoposide
Female
Humans
Ifosfamide
Infant
Male
Neoplasm Recurrence, Local
Pelvic Bones
Radiotherapy, Adjuvant
Research Support, N.I.H., Extramural
Sarcoma, Ewing's
Treatment Outcome
Vincristine
| | Abstract | PURPOSE: The impact of the modality used for local control of Ewing sarcoma is uncertain. We investigated the relationship between the type of local control modality, surgery, radiation (RT) or both (S + RT), and subsequent risk for local failure (LF) in patients with nonmetastatic pelvic Ewing sarcoma treated on INT-0091.
PATIENTS AND METHODS: Patients < or = 30 years with Ewing sarcoma, primitive neuroectodermal tumor or primitive sarcoma of bone were randomly assigned to receive chemotherapy with doxorubicin, vincristine, cyclophosphamide, and dactinomycin, (VACA) or with these four drugs alternating with ifosfamide and etoposide (VACA-IE). The local control modality, surgery, RT or both was chosen by the treating physicians. The effect of local control modality was assessed after adjusting for the size of tumor (< 8 cm, > or = 8 cm) and chemotherapy type.
RESULTS: Seventy-five patients with pelvic tumors and a median follow-up of 4.4 years (0.6 to 11.4 years) comprised the study population. Twelve underwent surgery, 44 received RT, and 19 received both. The 5-year event-free survival (EFS) and cumulative incidence of LF was 49% and 21% (16%, LF only; 5%, LF and distant failure). There was no significant difference in EFS or LF by tumor size (< 8 cm, > or = 8 cm), local control (LC) modality, or chemotherapy. However, VACA-IE seems to confer an LC benefit (11% v 30%; P = .06).
CONCLUSION: There was no significant effect of local control modality (surgery, RT or S + RT) selected by the treating physicians on rates of local failure or EFS. However, VACA-IE improves LC (11%) compared with previously published results for pelvic Ewing sarcoma. | | Language | eng | | Pub Type(s) | Journal Article
Randomized Controlled Trial
| | PubMed ID | 16921035 |
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