title: Local and distant control in non-metastatic pelvic Ewing's sarcoma patients.
abstract: OBJECTIVE
  Due to possible complication and loss of function, surgery is not often indicated in pelvic Ewing's sarcoma (ES). The purpose of this study was to review our experience and evaluate the role of different local treatment in non-metastatic pelvic ES patients.
  
  
  METHODS
  One hundred twenty-nine patients with pelvic ES were treated at our institution between 1975 and 1999. We excluded patients presenting metastases, patients who had died of other causes, or those with incomplete clinical documentation. Among the 73 eligible patients, 17 (23%) with progression of tumor growth during induction chemotherapy eventually died. The analysis was focused on the remaining 56 patients with good or stable clinical response to the chemotherapy.
  
  
  RESULTS
  Patients treated with surgery, with or without radiation therapy, had a better local control (82.6% vs. 66.7%) and a significantly higher rate of 5-year EFS (73.9% vs. 30.3%, P = 0.036) than those who were only treated with local radiation therapy.
  
  
  CONCLUSIONS
  Chemotherapy is the key factor in the treatment of pelvic ES. In our series, surgical treatment was associated with good prognosis for pelvic ES. The use of radiotherapy alone was less effective and should be only used in non-operable patients. Radiotherapy after surgery as a rescue method might not act effectively, while preoperative radiotherapy was associated with good clinical response and should be recommended.
authors.affiliation: Orthopaedic Surgery, Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy. davide.donati@ior.it
authors.forename: Davide
authors.initials: D
authors.lastname: Donati
authors.forename: Junqiang
authors.initials: J
authors.lastname: Yin
authors.forename: Claudia
authors.initials: C
authors.lastname: Di Bella
authors.forename: Marco
authors.initials: M
authors.lastname: Colangeli
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bacci
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Franco
authors.initials: F
authors.lastname: Bertoni
authors.forename: Enza
authors.initials: E
authors.lastname: Barbieri
authors.forename: Mario
authors.initials: M
authors.lastname: Mercuri
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007085:Ilium; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide