Treatment of children and adolescents with Ewing’s sarcoma family tumor of pelvis

Abstract

Ninety patients with Ewing sarcoma family tumors (ESFT) of the pelvis were treated in the Institute of Pediatric Oncology and Hematology between 1972 and 2007. Three different protocols of chemotherapy were used. Between 1972 to 1988 protocol consisted of VAC for the control group (CG) I: 32 pts, nonmetastatic - 25, disseminated - 7, between 1988 to 1997 of VACP for control group II: 30 pts, nonmetastatic - 23, disseminated - 7. From 1997 till 2007 induction chemotherapy (CT) for pts (28, nonmetastatic - 18, disseminated - 10) of investigation group (IG) III consisted of vincristine 1,5 mg/m²/d, days 1, 8, 15, adriamycin 37,5 mg/m²/d, days 1, 2 as a 24-h infusion, cyclophosphamide 2,1 gr/m²/d, days 1, 2 (1, 3, 5 cycles), and ifosfamide 2,4 gr/m²/d, days 1-5, etoposide 100 mg/m²/d, days 1-5 (2, 4 cycles). Local treatment consisted of radiotherapy in all cases. After local treatment pts of IG received HD CT with melphalan 140 mg/m², busulfan 16 mg/kg. PBCS were reinfused mean 6,0 x 10⁶ CD34+/kg. The 5-year disease-free survival rates were 3,1% for CG I; 13,3 for CG II and 69,8% for IG III. These results are significantly worse for CG I and II than the ones achieved in 28 patients of IG III with new innovative methods for treatment.