EWINGS-SARCOMA TREATMENT IN SCANDINAVIA 1984-1990 - 10-YEAR RESULTS OF THE SCANDINAVIAN SARCOMA GROUP PROTOCOL SSGIV

A report on the long-term follow up of the first cooperative Scandinav ian Sarcoma Group study in Ewing's sarcoma of bone is presented. Fifty -two previously untreated patients entered the study between 1984 and 1990. Half of the tumors were located in the extremities and one quart er in the pelvis. The combined modality treatment consisted of 5 cycle s of chemotherapy-including vincristine, methotrexate, doxorubicin, cy clophosphamide, bleomycin and dactinomycin. The first two cycles were followed by local resection or amputation in 35 patients and by radiot herapy alone in 17 patients. When surgery was not performed, was incom plete or yielded poor margins radiotherapy was given at a dose of 40-6 0 Gy Local tumor relapses developed in 10 patients and in all but one patient were accompanied by metastatic disease. Five patients had meta stasis at diagnosis and distant metastases developed after primary tre atment in 27 patients after a median of 14 months. The median follow-u p time for the 20 surviving patients is 10 years. At 5 years the tumor -related survival was 46% and the metastasis-free survival 43%. Late t umor relapses occurred in 4 patients, which reduced the 10-year tumor related survival to 41% and the metastasis-free survival to 38%. Histo pathological tumour response correlated with survival with 5-year meta stasis-free survival rates of 73% for the good responders and 35% for the poor responders.