title: Adjuvant and neoadjuvant chemotherapy for Ewing sarcoma family tumors in patients aged between 40 and 60: report of 35 cases and comparison of results with 586 younger patients treated with the same protocols in the same years.
abstract: BACKGROUND
  The clinical and pathologic features of 46 patients 40 to 60 years old with Ewing sarcoma family tumor (ESFT) diagnosed at the authors' institute between 1972 and 2000 were reviewed.
  
  
  METHODS
  Ten patients with metastatic tumors at presentation went elsewhere for treatment; 35 of 36 remaining cases with localized disease were treated at the authors' institution according to different chemotherapy protocols activated in successive years. In patients with nonmetastatic tumors local treatment was surgery in 9 patients, radiotherapy in 16, and surgery followed by radiotherapy in 10.
  
  
  RESULTS
  At follow-up times ranging from 6 and 34 years (mean, 17.8 years), 15 patients (42.9%) remained continuously disease-free, 19 experienced recurrence, and 1 died of chemotherapy-related toxicity. The 5- and 10-year event-free survivals were 42.9% and 35.2%, respectively, and the 5- and 10-year overall survivals were 46.1% and 42.8%, respectively. Comparing this group of patients with 586 cases of younger patients seen in the same period at Rizzoli, the only difference between the 2 groups was a significantly higher rate of tumors located in the soft tissues with a larger volume in the older group. The results achieved were comparable in the 2 groups, although the older group had a lower chemotherapy dose-intensity and a higher rate of WHO grade 4 hematologic toxicity.
  
  
  CONCLUSIONS
  For patients with localized disease treated with adjuvant and neoadjuvant chemotherapy the results were essentially comparable in the 2 groups. It is concluded that patients 40 years or older with ESFT should be treated in the same way as younger patients and included in treatment trials for these tumors.
authors.affiliation: Department of Chemotherapy, Rizzoli Orthopaedic Institute, Bologna, Italy. gaetano.bacci@ior.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bacci
authors.forename: Alba
authors.initials: A
authors.lastname: Balladelli
authors.forename: Cristiana
authors.initials: C
authors.lastname: Forni
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Alessandra
authors.initials: A
authors.lastname: Longhi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bacchini
authors.forename: Marco
authors.initials: M
authors.lastname: Alberghini
authors.forename: Nicola
authors.initials: N
authors.lastname: Fabbri
authors.forename: Mariaserena
authors.initials: M
authors.lastname: Benassi
authors.forename: Antonio
authors.initials: A
authors.lastname: Briccoli
authors.forename: Piero
authors.initials: P
authors.lastname: Picci
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011379:Prognosis; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome