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Among patients with high-risk Ewing’s sarcoma family of tumors (ESFT), treatment with an intensified chemotherapy regimen of ifosfamide, carboplatin, and etoposide (ICE) plus cyclophosphamide, doxorubicin, and vincristine (CAV) resulted in good control of disease and made it easier to perform surgery. These results were published in the journal Cancer.

The Ewing’s Sarcoma family of tumors includes Ewing’s sarcoma as well as peripheral primitive neuroepithelial tumor. These are rare diseases in which cancerous cells affect the bone and soft tissues. They are most common in teenagers and young adults. Ewing’s sarcoma can occur in any bone of the body, although the most frequent sites are the pelvis, thigh, lower leg, upper arm, and ribs. Ewing’s may also arise in the soft tissues of the body.

The prognosis for Ewing’s depends on the choice of treatment, the location of the tumor, the size of the tumor, the stage of the cancer (how far it has spread), how the tumor responds to treatment as well as the patient’s age and overall health.

To evaluate an intensified chemotherapy regimen for ESFT, researchers in Italy conducted a pilot study among 38 patients with high-risk ESFT.

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Patients were classified as high-risk if they had a large tumor volume, a tumor site with a poor prognosis, or cancer that had spread to the bone marrow or lungs. Half the patients received chemotherapy with ICE (ifosfamide, carboplatin, and etoposide) plus CAV (cyclophosphamide, doxorubicin, and vincristine) and half the patients received a variety of other chemotherapy regimens.

  • Cancer was brought under control more rapidly in the patients treated with ICE plus CAV.
  • Surgery was more easily performed in the patients treated with ICE plus CAV.
  • 90% of patients treated with ICE plus CAV responded to treatment.
  • Estimated three-year survival among patients treated with ICE plus CAV was 67%.

The researchers conclude that in this small study of patients with high-risk Ewing’s sarcoma, the chemotherapy regimen of ICE plus CAV resulted in good control of the disease. A study involving a larger number of patients and longer follow-up is necessary to confirm the risks and benefits of this approach.

Reference: Milano GM, Cozza R, Ilari I et al. High Histologic and Overall Response to Dose Intensification of Ifosfamide, Carboplatin, and Etoposide with Cyclophosphamide, Doxorubicin, and Vincristine in Patients with High-Risk Ewing Sarcoma. Cancer . Early Online Publication March 10, 2006.