title: Local therapy and other factors influencing site of relapse in patients with localised Ewing's sarcoma. United Kingdom Children's Cancer Study Group (UKCCSG).
abstract: 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 primary chemotherapy. Although not strictly comparable, due to the clinical indications 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 therapy: radiotherapy (4/56), surgery (4/114) or a combination (0/20). Overall survival 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 that with effective intensive chemotherapy combined with either radiotherapy or surgery, local control in this study was excellent at sites other than the pelvis. Preventing distant relapse, predominantly to lung and bone, remains the major challenge.
authors.affiliation: Paediatric Department, Royal Marsden NHS Trust, Sutton, Surrey, U.K.
authors.forename: A G
authors.initials: AG
authors.lastname: Shankar
authors.forename: C R
authors.initials: CR
authors.lastname: Pinkerton
authors.forename: A
authors.initials: A
authors.lastname: Atra
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: I
authors.initials: I
authors.lastname: Lewis
authors.forename: D
authors.initials: D
authors.lastname: Spooner
authors.forename: S
authors.initials: S
authors.lastname: Cannon
authors.forename: R
authors.initials: R
authors.lastname: Grimer
authors.forename: S J
authors.initials: SJ
authors.lastname: Cotterill
authors.forename: A W
authors.initials: AW
authors.lastname: Craft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007223:Infant; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012512:Sarcoma, Ewing / Q000628:therapy*; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D007069:Ifosfamide