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Nonmetastatic Ewing family tumors: high-dose chemotherapy with stem cell rescue in poor responder patients. Results of the Italian Sarcoma Group/Scandinavian Sarcoma Group III protocol

Ferrari, S.; Hall, K. Sundby; Luksch, R.; Tienghi, A.; Wiebe, Thomas LU ; Fagioli, F.; Alvegård, Thor LU ; del Prever, A. Brach; Tamburini, A. and Alberghini, M., et al. (2011) In Annals of Oncology 22(5). p.1221-1227
Abstract
Background: High-dose chemotherapy (HDT) was added to conventional chemotherapy in Ewing sarcoma family tumor (EFT) patients, poor responders (PRs) to induction chemotherapy in order to improve their survival. Patients and methods: Patients aged <= 40 years with nonmetastatic Ewing sarcoma (ES) received vincristine (V), doxorubicin (A), cyclofosfamide (C), actinomycin (Ac), ifosfamide (I) and etoposide (E) (VACAc-IE regimen) as induction chemotherapy. As maintenance treatment, good responders (GR) received nine cycles of VACAc-IE regimen. PRs received three cycles of VAC-IE, mobilizing cycle with CE and HDT with Busulfan and Melphalan with stem cell support. Results: Three hundred patients [median age 15 years (3-40 years)] entered the... (More)
Background: High-dose chemotherapy (HDT) was added to conventional chemotherapy in Ewing sarcoma family tumor (EFT) patients, poor responders (PRs) to induction chemotherapy in order to improve their survival. Patients and methods: Patients aged <= 40 years with nonmetastatic Ewing sarcoma (ES) received vincristine (V), doxorubicin (A), cyclofosfamide (C), actinomycin (Ac), ifosfamide (I) and etoposide (E) (VACAc-IE regimen) as induction chemotherapy. As maintenance treatment, good responders (GR) received nine cycles of VACAc-IE regimen. PRs received three cycles of VAC-IE, mobilizing cycle with CE and HDT with Busulfan and Melphalan with stem cell support. Results: Three hundred patients [median age 15 years (3-40 years)] entered the study. One patient refused local treatment, 242 (81%) underwent surgery [with radiotherapy (RT) in 80] and 57 (19%) RT alone. No toxic deaths were recorded. Overall GR were 146 (49%). Twenty-eight PR did not receive HDT. At a median follow-up of 64 months (21-116 months), 5-year overall and event-free survival (EFS) were 75% and 69%, respectively. Five-year EFS was 75% for GR, 72% for PR treated with HDT and 33% for PR who did not receive HDT. Conclusions: High-dose therapy added to the VACA-IE regimen in PR patients is feasible and effective. Selected groups of patients with ES can benefit from HDT. (Less)
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publication status
published
subject
keywords
chemotherapy-induced necrosis, Ewing sarcoma, high-dose chemotherapy
in
Annals of Oncology
volume
22
issue
5
pages
1221 - 1227
publisher
Oxford University Press
external identifiers
  • wos:000290049600032
  • scopus:79955502856
ISSN
1569-8041
DOI
10.1093/annonc/mdq573
language
English
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yes
id
5c54b74f-2c87-4492-a605-2a6c23dd4a6c (old id 1964711)
date added to LUP
2011-06-01 10:39:14
date last changed
2017-11-19 03:44:02
@article{5c54b74f-2c87-4492-a605-2a6c23dd4a6c,
  abstract     = {Background: High-dose chemotherapy (HDT) was added to conventional chemotherapy in Ewing sarcoma family tumor (EFT) patients, poor responders (PRs) to induction chemotherapy in order to improve their survival. Patients and methods: Patients aged &lt;= 40 years with nonmetastatic Ewing sarcoma (ES) received vincristine (V), doxorubicin (A), cyclofosfamide (C), actinomycin (Ac), ifosfamide (I) and etoposide (E) (VACAc-IE regimen) as induction chemotherapy. As maintenance treatment, good responders (GR) received nine cycles of VACAc-IE regimen. PRs received three cycles of VAC-IE, mobilizing cycle with CE and HDT with Busulfan and Melphalan with stem cell support. Results: Three hundred patients [median age 15 years (3-40 years)] entered the study. One patient refused local treatment, 242 (81%) underwent surgery [with radiotherapy (RT) in 80] and 57 (19%) RT alone. No toxic deaths were recorded. Overall GR were 146 (49%). Twenty-eight PR did not receive HDT. At a median follow-up of 64 months (21-116 months), 5-year overall and event-free survival (EFS) were 75% and 69%, respectively. Five-year EFS was 75% for GR, 72% for PR treated with HDT and 33% for PR who did not receive HDT. Conclusions: High-dose therapy added to the VACA-IE regimen in PR patients is feasible and effective. Selected groups of patients with ES can benefit from HDT.},
  author       = {Ferrari, S. and Hall, K. Sundby and Luksch, R. and Tienghi, A. and Wiebe, Thomas and Fagioli, F. and Alvegård, Thor and del Prever, A. Brach and Tamburini, A. and Alberghini, M. and Gandola, L. and Mercuri, M. and Capanna, R. and Mapelli, S. and Prete, A. and Carli, M. and Picci, P. and Barbieri, E. and Bacci, G. and Smeland, S.},
  issn         = {1569-8041},
  keyword      = {chemotherapy-induced necrosis,Ewing sarcoma,high-dose chemotherapy},
  language     = {eng},
  number       = {5},
  pages        = {1221--1227},
  publisher    = {Oxford University Press},
  series       = {Annals of Oncology},
  title        = {Nonmetastatic Ewing family tumors: high-dose chemotherapy with stem cell rescue in poor responder patients. Results of the Italian Sarcoma Group/Scandinavian Sarcoma Group III protocol},
  url          = {http://dx.doi.org/10.1093/annonc/mdq573},
  volume       = {22},
  year         = {2011},
}