Improving Outcomes After Relapse in Ewing's Sarcoma: Analysis of 114 Patients From a Single Institution

[摘要] The outcome for patients with relapsed Ewing's sarcoma is poor. A retrospectiveanalysis was carried out to identify factors associated with improved survival.Between 1992 and 2002, 114 patients presented with relapsed or progressive disease.Median time to progression/relapse was 13 months (range, 2–128). Treatment atrelapse included high dose treatment (HDT) in 29 patients, and surgery or definitiveradiotherapy in 29. 2 and 5-year post relapse survival (PRS) was 23.5% and 15.2%,respectively. In multivariate analysis, the most significant factors associated withimproved survival were disease confined locally or to the lungs (2-year PRS, 40%versus 6%;P<.001), relapse>18months from diagnosis (2-year PRS, 53% versus8%;P<.001), HDT at relapse (2-year PRS, 62% versus 11%;P<.001), and surgeryand/or radiotherapy at relapse (2-year PRS, 51% versus 14%;P<.001). First treatment failure in Ewing's sarcoma is mostly fatal. Improved survival can beachieved in selective patients with aggressive treatment. These improvements areconfined to those without bone or bone marrow metastases.

[学科分类] 肿瘤学