title: Ewing sarcoma: favourable results with combined modality therapy and conservative use of radiotherapy.
abstract: BACKGROUND
  At the Hospital for Sick Children (HSC), we have treated Ewing sarcoma (ES) with multi-agent chemotherapy, surgery and conservative use of radiotherapy for local control. Our objective was to describe the outcome and prognostic factors associated with this strategy.
  
  
  METHODS
  We performed a retrospective chart review of children diagnosed with ES at HSC from Feb 1984 to June 1999.
  
  
  RESULTS
  Seventy-two evaluable children were identified. All received chemotherapy. Local control administered was surgery (n = 37), radiation (n = 23), both (n = 10) or neither (n = 2). The 7-year EFS was 66.4%. Recurrence occurred in 23 patients, 7 locally and 16 distantly. Better EFS was associated with male gender (78.5% vs. 52.1%; P = 0.007), localised disease (77.0% vs. 39.4%; P = 0.0004), extremity primary (88.2% vs. 52.8%; P = 0.005) and non-pelvic primary (75.7% vs. 18.2%; P < 0.0001).
  
  
  CONCLUSIONS
  Favourable outcomes were seen for patients treated with multi-agent chemotherapy, surgery and conservative use of radiotherapy. Metastatic disease rather than local control was the major cause of failure.
authors.affiliation: Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Zogopoulos
authors.forename: Lindsay
authors.initials: L
authors.lastname: Teskey
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.forename: David
authors.initials: D
authors.lastname: Dix
authors.forename: Ronald
authors.initials: R
authors.lastname: Grant
authors.forename: Mark L
authors.initials: ML
authors.lastname: Greenberg
authors.forename: Sheila
authors.initials: S
authors.lastname: Weitzman
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D018709:Statistics, Nonparametric; D015996:Survival Rate