MEGATHERAPY IN CHILDREN WITH HIGH-RISK EWINGS-SARCOMA IN FIRST COMPLETE REMISSION

To improve the prognosis of patients with metastatic or high-risk loca lized sarcoma in first CR, we explored the role of consolidation thera py with megatherapy and hematopoietic rescue, From 1986 to 1995, of 72 patients with Ewing's sarcoma from three pediatric departments, 30 we re diagnosed as high-risk patients, Of these 30 patients, six did not achieve complete remission and four refused megatherapy and received m ultimodal treatment (chemotherapy + surgery and/or radiotherapy). The remaining 20 patients received megatherapy, There were 15 males and fi ve females with a median age of 10.8 years (range 2-18 years). Five pa tients had metastatic disease at initial diagnosis, nine patients had primary tumor in the pelvis and 13 had a tumor volume greater than 100 mi, Overall disease-free survival was 62.7 +/- 11%; 40 +/- 21.9% for those with metastatic disease, 76.2 +/- 12.2% for those with tumor vol ume greater than 100 mi and 64.8 +/- 16.5% for those with tumor in pel vic bones, In conclusion, megatherapy has improved the outcome of this group of patients relative to that expected following conventional th erapy.