Radiotherapy and High-Dose Chemotherapy in Advanced Ewing's Tumors

Pape, H.; Laws, Hans‐Jürgen; Burdach, Stefan; Kaik, B. van; Glag, M.; Gripp, Stephan; Wittkamp, M.; Jürgens, H.; Göbel, U.; Schmitt, G

doi:10.1007/s000660050058

Cited by 18 publications

(13 citation statements)

References 13 publications

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“…Total body irradiation and single agent chemotherapy have been used as high-dose therapy but was relatively ineffective in controlling advanced disease [13][14][15][16][17][18]. However, TBI-containing myeloablative regimens have been reported to improve EFS of high-risk ES [1,[19][20][21][22]. Burdach et al reported a 6-year EFS of 45% for patients who received HDC and TBI followed by stem cell rescue compared to 2% for the historical control group of patients who were treated with chemotherapy only [8].…”

Section: Discussionmentioning

confidence: 99%

Does consolidation with autologous stem cell transplantation improve the outcome of children with metastatic or relapsed Ewing sarcoma?

Al-Faris

Harbi

Goia

et al. 2007

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 99%

Does consolidation with autologous stem cell transplantation improve the outcome of children with metastatic or relapsed Ewing sarcoma?

Al-Faris

Harbi

Goia

et al. 2007

Pediatric Blood & Cancer

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“…Primary multifocal Ewing's sarcoma has been associated with an unfavorable prognosis, as evidenced by a 2-year event-free survival of 15% to 31% [3,19,26]. When compared to other patients with advanced Ewing's tumors (ie, those relapsing within 2 years of chemotherapy or suffering multiple relapses), patients with primary multifocal disease treated with contemporary chemotherapy and myeloablative therapy showed a trend toward lower rates of event-free survival at 5 years (0% to 25% versus 24% to 28% for all advanced Ewing's tumors) [5-8, 20, 24, 26].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…High-intensity protocols have been advocated as a means of minimizing cumulative chemotherapy dose, secondarily reducing individual risk for development of secondary malignancies [5]. The incorporation of totalbody irradiation into the myeloablative regimen has been associated with poorer outcomes (seen with irradiation of greater than 30% of total bone marrow), increased incidence of secondary malignancies, and increased mortality from infection and respiratory complications [7,26]. Stem cell transplantation has been implemented as an adjunct to high-intensity chemotherapy, and it is required for rescue when greater than 50% of the bone marrow is irradiated; outcomes have been similar between allogeneic and autologous stem cell transplantation [7,8].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Chronic Bilateral Thigh and Knee Discomfort in an 18-year-old Man

Templeton

Bauer

Lietman

2008

Clinical Orthopaedics &Amp; Related Research

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An 18-year-old man presented with severe, intermittent bilateral thigh and knee pain of approximately 6 months' duration. His symptoms had initially manifested as localized anterior left knee pain 2 years earlier, and he had been treated with high-dose ibuprofen and physical therapy for the presumptive diagnosis of patellofemoral syndrome. Despite attempts at nonoperative management, he had experienced progressive discomfort involving the left thigh, right knee, and right thigh. At the time of presentation, he described pain principally in the left thigh, characterized as self-remitting and without clear antecedent. He also noted long-standing night pain interfering with sleep but denied any fevers, chills, rigors, weight loss, or other constitutional symptoms. A review of systems was otherwise negative, and medical history was unremarkable.Physical examination revealed mildly shortened stance phase with respect to the left lower extremity; the patient noted his limp had been more pronounced during the preceding month. Pelvic compression and palpation along the spinal column and long bones of the lower extremities elicited no focal tenderness. No visible lesions or palpable masses were observed in the trunk or upper or lower extremities. Active and passive range of motion of the hips and knees were full and well tolerated. The patient was neurologically intact with normal sensation to light touch and full motor strength in all muscle groups.Laboratory studies revealed normal white blood cell count Plain radiographs of the left femur (Fig. 1), computerized tomography (CT) scan of the pelvis and bilateral femora, radionuclide scan (Fig. 2), and magnetic resonance imaging (MRI) of the right acetabulum and bilateral femora (Fig. 3) were obtained.Based on the history, physical examination, and imaging studies, what is the differential diagnosis? Imaging InterpretationRadiographs of the left femur (Fig. 1) revealed an osteolytic lesion extending from the intertrochanteric region to the middiaphysis. The lesion demonstrated mild bony remodeling and cortical thickening most evident in the diaphysis with a well-defined proximal margin.A noncontrast CT scan performed through the pelvis and bilateral femora demonstrated multifocal osteolytic lesions in the left femur, right femur, and superior right Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution has approved or waived approval for the reporting of this case and that all investigations were conducted in conformity with ethical principles of research.

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“…Four factors that are known to be related with outcome were chosen for the analysis: tumor size, tumor location, initial metastatic status and response to initial chemotherapy [3,7,9,12,15,20,22,27]. Furthermore postoperative interval until the onset of irradiation (>/≤ 60 days) was chosen and the study in which patients were treated.…”

Section: Radical Resection: the Whole Tumor-bearing Compartment Is Rementioning

confidence: 99%

Postoperative Radiotherapy in the Treatment of Ewing Tumors: Influence of the Interval between Surgery and Radiotherapy

Schuck

Rübe²,

Könemann

et al. 2002

Strahlentherapie und Onkologie

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Radiotherapy and High-Dose Chemotherapy in Advanced Ewing's Tumors

Abstract: High-dose chemotherapy can improve outcome in poor prognostic advanced Ewing's tumors. The disease itself remains the main problem. The expected engraftment problems after intensive radiotherapy in large volumes of bone marrow can be overcome by stem cell reinfusion.

Cited by 18 publications

References 13 publications

Does consolidation with autologous stem cell transplantation improve the outcome of children with metastatic or relapsed Ewing sarcoma?

Does consolidation with autologous stem cell transplantation improve the outcome of children with metastatic or relapsed Ewing sarcoma?

Chronic Bilateral Thigh and Knee Discomfort in an 18-year-old Man

Postoperative Radiotherapy in the Treatment of Ewing Tumors: Influence of the Interval between Surgery and Radiotherapy

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