title: [EICESS 92 (European Intergroup Cooperative Ewing's Sarcoma Study)-- preliminary results].
abstract: BACKGROUND
  Ewing tumor patients' outcome is 50% to 60% with current treatment strategies. Questions concerning toxicity and secondary malignancies are of increasing importance.
  
  
  METHODS
  631 patients were registered with the German EICESS study center of the European Intergroup Cooperative Ewing's Sarcoma Study, 369 patients were randomized. Treatment apart from local therapy consisted of 14 courses of Vincristine, Actinomycin D, Cyclophosphamide or Ifosfamide, Adriamycin (Doxorubicin), with or without Etoposide. First results concerning event-free survival (EFS), toxicity, and the rate of secondary malignancies three years after diagnosis are presented.
  
  
  RESULTS
  Three year EFS was 0.66 for patients with localized tumors, 0.43 for patients with primary pulmonary/pleural metastases, and 0.29 for patients with other metastases, respectively. Large tumor volume or pelvic site, especially if inoperable, were adverse prognostic factors. Both histological and MRT-defined response were positively correlated to outcome. Up to 67% of patients experienced WHO grade IV toxicity, mostly related to bone marrow depression. The treatment related mortality was 1% (6/631). Until 15.02.1999, six of 687 patients have suffered secondary malignancies, two of six after (additional) myeloablative therapy.
  
  
  CONCLUSIONS
  EICESS 92 treatment is toxic, but manageable and compares favorably to international results. New strategies must be sought for certain risk groups of patients.
authors.affiliation: Klinik und Poliklinik für Pädiatrische Onkologie und Hämatologie, Westfälische Wilhelms Universität Münster. paulusm@uni-muenster.de
authors.forename: M
authors.initials: M
authors.lastname: Paulussen
authors.forename: S
authors.initials: S
authors.lastname: Ahrens
authors.forename: G
authors.initials: G
authors.lastname: Braun-Munzinger
authors.forename: A W
authors.initials: AW
authors.lastname: Craft
authors.forename: B
authors.initials: B
authors.lastname: Dockhorn-Dworniczak
authors.forename: W
authors.initials: W
authors.lastname: Dörffel
authors.forename: J
authors.initials: J
authors.lastname: Dunst
authors.forename: B
authors.initials: B
authors.lastname: Fröhlich
authors.forename: U
authors.initials: U
authors.lastname: Göbel
authors.forename: M
authors.initials: M
authors.lastname: Häussler
authors.forename: T
authors.initials: T
authors.lastname: Klingebiel
authors.forename: E
authors.initials: E
authors.lastname: Koscielniak
authors.forename: U
authors.initials: U
authors.lastname: Mittler
authors.forename: C
authors.initials: C
authors.lastname: Rübe
authors.forename: W
authors.initials: W
authors.lastname: Winkelmann
authors.forename: P A
authors.initials: PA
authors.lastname: Voûte
authors.forename: A
authors.initials: A
authors.lastname: Zoubek
authors.forename: H
authors.initials: H
authors.lastname: Jürgens
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D005060:Europe; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D016609:Neoplasms, Second Primary; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000556:secondary; D016019:Survival Analysis; D016896:Treatment Outcome