Multimodal therapy for localized Ewing's sarcoma of bone mature results ofthe T-9 protocol

This study was conducted to assess the long-term results of combined modali ty therapy For localized Ewing's sarcoma of bone. A retrospective review of 25 patients (19 males and 6 females; median age, 16 years) treated between 1983 and 1990 was performed. Neoadjuvant and adjuvant chemotherapy were gi ven according to the T-9 protocol. Radiation therapy was the primary local control approach. Nineteen patients (76%) achieved disease-free status, but 9 of them (47%) relapsed thereafter. Late recurrences (more than 4 years s ince diagnosis) were seen in 4 patients. Median follow-up for surviving pat ients was 108 months. The actuarial overall survival and disease-free survi val rates were 60% and 48% at 5 years, and 38% and 33% at 10 years. Axial t umor location and increased serum lactate dehydrogenase levels were signifi cant poor prognostic factors, In conclusion, despite aggressive combined th erapy, patients with Ewing's sarcoma have a significant risk of late relaps e. More effective treatments are needed and long-term reports of promising protocols should be encouraged.