THE POTENTIAL CURABILITY OF EWING'S SARCOMA IN CHILDREN

Abstract

Four drug adjuvant chemotherapy (dactinomycin, adriamycin, vincristine and cyclophosphamide) was added to local radiation therapy to treat patients with Ewing's sarcoma. The entire involved bone was treated with 6000-7000 rads (Co⁶⁰). Cyclic chemotherapy was started concomitantly with radiation therapy, and was continued for 24 months. Of 14 patients, 10 had no evidence of metastatic disease, 2 had bone marrow invasion with extrinsic cells, and 2 others had pulmonary metastases at the time of diagnosis. The latter 2 received irradiation (2000 rads) to the lungs. 13/14 patients are free of disease for a median time of 24 months from the time of diagnosis. Seven of these patients having completed chemotherapy, remain free of disease for from 2-24 months after the cessation of chemotherapy. One patient developed metastatic disease at 32 months (6 months after stopping therapy). Meningeal disease has not been observed in any of the 14 patients. Major complications included reversible congestive heart failure in 2 patients (necessitating lowering the cumulative dose of adriamycin for subsequent patients) and the local effects of combined therapy on the primary tumor site attributable to the devitalizatlon of bone and soft tissue.

These preliminary results indicate that Ewing's sarcoma may be a potentially curable disease with early referral to centers equipped to institute aggressive combined therapy.

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