title: A long-term review of the treatment of patients with Ewing's sarcoma in one institution.
abstract: OBJECTIVE
  The treatment of patients suffering from Ewing's sarcoma has changed over the last three decades. We report the analyses, significant prognostic factors, interdisciplinary approach and development of therapy in one institution in Austria.
  
  
  METHODS
  One hundred and forty-two patients treated for Ewing's sarcoma between 1949 and 1994 were reviewed. Median follow-up was 8.5 years. Fifty-six patients were treated between 1949 and 1980 (group 1), and 86 patients between 1981 and 1994 (group 2). Patients in group 1 were treated with polychemotherapy. Patients in group 2 were treated with a neoadjuvant CESS (Cooperative Ewing's Sarcoma Study) regimen. In group 1, 24 patients underwent biopsy only, 32 patients had a definitive operation, 48 patients received either radiation therapy only or additional radiation therapy compared with in group 2: 6, 80 and 44 cases, respectively.
  
  
  RESULTS
  Five-year overall survival (OS) increased from 27% to 57%. Significant prognostic factors for OS were pre-operative metastases (P=0.0001), tumour location (P=0.0048), type of chemotherapy (P=0.002) and response to chemotherapy (P=0.0004). Chemotherapy (P=0.037), tumour location (P=0.0017) and metastases at diagnosis (P=0.0025) were significant.
  
  
  CONCLUSIONS
  The most effective treatment of Ewing's sarcoma is chemotherapy.
authors.affiliation: Department of Orthopaedics, University of Vienna, Vienna, Austria. maria.sluga@akh-wien.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Sluga
authors.forename: R
authors.initials: R
authors.lastname: Windhager
authors.forename: S
authors.initials: S
authors.lastname: Lang
authors.forename: H
authors.initials: H
authors.lastname: Heinzl
authors.forename: P
authors.initials: P
authors.lastname: Krepler
authors.forename: F
authors.initials: F
authors.lastname: Mittermayer
authors.forename: M
authors.initials: M
authors.lastname: Dominkus
authors.forename: A
authors.initials: A
authors.lastname: Zoubek
authors.forename: R
authors.initials: R
authors.lastname: Kotz
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001317:Austria; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000379:methods; D011336:Probability; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome