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Post-Relapse Survival in Patients With Ewing Sarcoma

Ferrari, Stefano; Luksch, Roberto; Hall, Kirsten Sundby; Fagioli, Franca; Prete, Arcangelo; Tamburini, Angela; Tienghi, Amelia; DiGirolamo, Stefania; Paioli, Anna and Abate, Massimo Eraldo, et al. (2015) In Pediatric Blood & Cancer 62(6). p.994-999
Abstract
BackgroundPost-relapse survival (PRS) was evaluated in patients with Ewing sarcoma (EWS) enrolled in chemotherapy protocols based on the use of high-dose chemotherapy with busulfan and melfalan (HDT) as a first-line consolidation treatment in high-risk patients. ProcedureEWS patients enrolled in ISG/SSG III and IV trials who relapsed after complete remission were included in the analysis. At recurrence, chemotherapy based on high-dose ifosfamide was foreseen, and patients who responded but had not received HDT underwent consolidation therapy with HDT. ResultsData from 107 EWS patients were included in the analysis. Median time to recurrence (RFI) was 18 months, and 45 (42%) patients had multiple sites of recurrence. Patients who had... (More)
BackgroundPost-relapse survival (PRS) was evaluated in patients with Ewing sarcoma (EWS) enrolled in chemotherapy protocols based on the use of high-dose chemotherapy with busulfan and melfalan (HDT) as a first-line consolidation treatment in high-risk patients. ProcedureEWS patients enrolled in ISG/SSG III and IV trials who relapsed after complete remission were included in the analysis. At recurrence, chemotherapy based on high-dose ifosfamide was foreseen, and patients who responded but had not received HDT underwent consolidation therapy with HDT. ResultsData from 107 EWS patients were included in the analysis. Median time to recurrence (RFI) was 18 months, and 45 (42%) patients had multiple sites of recurrence. Patients who had previously been treated with HDT had a significantly (P=0.02) shorter RFI and were less likely to achieve a second complete remission (CR2). CR2 status was achieved by 42 (39%) patients. Fifty patients received high-dose IFO (20 went to consolidation HDT). The 5-year PRS was 19% (95% CI 11 to 27%). With CR2, the 5-year PRS was 48% (95% CI 31 to 64%). Without CR2, median time to death was six months (range 1-45 months). According to the multivariate analysis, patients younger than 15 years, recurrence to the lung only, and RFI longer than 24 months significantly influenced the probability of PRS. ConclusionsAge, pattern of recurrence, RFI, and response to second-line chemotherapy influence post-relapse survival in patients with recurrent Ewing sarcoma. No survival advantage was observed from chemotherapy consolidation with HDT. Pediatr Blood Cancer 2015;62:994-999. (c) 2015 Wiley Periodicals, Inc. (Less)
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published
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keywords
Ewing sarcoma, metastases, chemotherapy, high-dose chemotherapy
in
Pediatric Blood & Cancer
volume
62
issue
6
pages
994 - 999
publisher
John Wiley and Sons Inc.
external identifiers
  • wos:000353231500013
  • scopus:84927909766
ISSN
1545-5017
DOI
10.1002/pbc.25388
language
English
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yes
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868d68c4-59e4-4478-ab1c-ad27d1e74b23 (old id 5386001)
date added to LUP
2015-06-01 09:27:17
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2017-04-09 03:16:30
@article{868d68c4-59e4-4478-ab1c-ad27d1e74b23,
  abstract     = {BackgroundPost-relapse survival (PRS) was evaluated in patients with Ewing sarcoma (EWS) enrolled in chemotherapy protocols based on the use of high-dose chemotherapy with busulfan and melfalan (HDT) as a first-line consolidation treatment in high-risk patients. ProcedureEWS patients enrolled in ISG/SSG III and IV trials who relapsed after complete remission were included in the analysis. At recurrence, chemotherapy based on high-dose ifosfamide was foreseen, and patients who responded but had not received HDT underwent consolidation therapy with HDT. ResultsData from 107 EWS patients were included in the analysis. Median time to recurrence (RFI) was 18 months, and 45 (42%) patients had multiple sites of recurrence. Patients who had previously been treated with HDT had a significantly (P=0.02) shorter RFI and were less likely to achieve a second complete remission (CR2). CR2 status was achieved by 42 (39%) patients. Fifty patients received high-dose IFO (20 went to consolidation HDT). The 5-year PRS was 19% (95% CI 11 to 27%). With CR2, the 5-year PRS was 48% (95% CI 31 to 64%). Without CR2, median time to death was six months (range 1-45 months). According to the multivariate analysis, patients younger than 15 years, recurrence to the lung only, and RFI longer than 24 months significantly influenced the probability of PRS. ConclusionsAge, pattern of recurrence, RFI, and response to second-line chemotherapy influence post-relapse survival in patients with recurrent Ewing sarcoma. No survival advantage was observed from chemotherapy consolidation with HDT. Pediatr Blood Cancer 2015;62:994-999. (c) 2015 Wiley Periodicals, Inc.},
  author       = {Ferrari, Stefano and Luksch, Roberto and Hall, Kirsten Sundby and Fagioli, Franca and Prete, Arcangelo and Tamburini, Angela and Tienghi, Amelia and DiGirolamo, Stefania and Paioli, Anna and Abate, Massimo Eraldo and Podda, Marta and Cammelli, Silvia and Eriksson, Mikael and del Prever, Adalberto Brach},
  issn         = {1545-5017},
  keyword      = {Ewing sarcoma,metastases,chemotherapy,high-dose chemotherapy},
  language     = {eng},
  number       = {6},
  pages        = {994--999},
  publisher    = {John Wiley and Sons Inc.},
  series       = {Pediatric Blood & Cancer},
  title        = {Post-Relapse Survival in Patients With Ewing Sarcoma},
  url          = {http://dx.doi.org/10.1002/pbc.25388},
  volume       = {62},
  year         = {2015},
}