title: Ewing's tumors over the age of 40: a retrospective analysis of 47 patients treated according to the International Clinical Trials EICESS 92 and EURO-E.W.I.N.G. 99.
abstract: BACKGROUND
  Ewing's tumors (ET) are rare in patients over the age of 40 years. Published data on presentation, treatment, and clinical outcome are limited.
  
  
  METHODS
  We present a retrospective analysis of data from 47 patients in this age group diagnosed with ET and enrolled in the 2 consecutive trials, EICESS 92 and EURO-E.W.I.N.G. 99. The median age at diagnosis was 47.7 years (range, 40-68.6 years).
  
  
  RESULTS
  The median follow-up was 2.23 years from diagnosis (range, 0.35-12.92 years). 72.3% of patients were found to have localized disease, and 27.7% had primary metastases. Good clinical response to induction therapy was observed in 55%, and 73% of patients showed good histological response. The event-free survival was 0.77 at 1 year and 0.50 at 3 years (n = 44).
  
  
  CONCLUSIONS
  ET are rare in patients over the age of 40 years. With adequate multimodal therapy, the results in terms of survival are comparable to those in adolescence. Specific age-adapted treatment regimens are not established. Patients should be enrolled in international trials, and if necessary treatment should be adjusted for lower tolerance and co-morbidity.
authors.affiliation: Dept. of Pediatric Hematology and Oncology, University Children's Hospital, Munster, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Pieper
authors.forename: Andreas
authors.initials: A
authors.lastname: Ranft
authors.forename: Gabriele
authors.initials: G
authors.lastname: Braun-Munzinger
authors.forename: Heribert
authors.initials: H
authors.lastname: Jurgens
authors.forename: Michael
authors.initials: M
authors.lastname: Paulussen
authors.forename: Uta
authors.initials: U
authors.lastname: Dirksen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome