Local therapy and other factors influencing site of relapse in patients with localised Ewing's sarcoma

Relapse patterns have been documented in 191 children with localised Ewing' s sarcoma treated with the United Kingdom Children's Cancer Group (UKCCSG) Ewing's Tumour regimen ET2. All received chemotherapy comprising ifosfamide , vincristine, doxorubicin and actinomycin D. Local treatment modality was excision and or radiotherapy depending on tumour site and response to prima ry chemotherapy. Although not strictly comparable, due to the clinical indi cations used for each modality, local relapse rates were very low and were similar, irrespective of the type of local treatment modality: radiotherapy (3/56), surgery (7/114) or a combination (0/20). Combined relapse (local distant) rates were similarly low irrespective of the type of local therap y: radiotherapy (4/56), surgery (4/114) or a combination (0/20). Overall su rvival was lower in females (P=<0.04), older children (P=<0.002) and those with primaries at sites other than long bones (P=<0.02). It is concluded th at with effective intensive chemotherapy combined with either radiotherapy or surgery, local control in this study was excellent at sites other than t he pelvis. Preventing distant relapse, predominantly to lung and bone, rema ins the major challenge. (C) 1999 Elsevier Science Ltd. All rights reserved .