Efficacy of carbon-ion radiotherapy and high-dose chemotherapy for patients with unresectable Ewing's sarcoma family of tumors.
BACKGROUND
Treatment for unresectable Ewing's sarcoma family of tumors (ESFT) is a formidable challenge because of its high tendency for local and distant failure. Recently, carbon-ion radiotherapy (CIRT) has been applied to unresectable bone and soft tissue sarcoma. Additionally, high-dose chemotherapy (HDC) with stem cell rescue has been used to improve the survival of patients with relapsed ESFT. Here we report our experience with CIRT and HDC in the treatment of unresectable ESFT.


METHODS
Five unresectable ESFT patients including 4 who underwent CIRT and HDC and one who underwent CIRT from 1999-2009 were retrospectively studied. After neoadjuvant chemotherapy, CIRT was conducted at the National Institute of Radiological Sciences in Chiba as local therapy. Consecutively, we employed HDC including busulfan, melphalan, and thiotepa with stem cell rescue.


RESULTS
Two patients showed tumor shrinkage after CIRT, including 1 patient who achieved partial response. No severe acute toxicity related to CIRT was observed. Local failure was observed in only 1 patient at 22 months after CIRT. Four patients conducted HDC with stem cell rescue after CIRT and 1 patient suffered from veno-occlusive disease just after HDC. Distant failure was observed in 3 patients after completion of the treatment.


CONCLUSIONS
CIRT and HDC for unresectable ESFT patients show favorable local control, with unsatisfactory results for distant control.
Division of Orthopedic Surgery, Chiba Cancer Center, Nitona 666-2, Chuo-ku, Chiba, 260-8717, Japan, siwata@chiba-cc.jp.
Shintaro
S
Iwata
Tsukasa
T
Yonemoto
Takeshi
T
Ishii
Kyoya
K
Kumagai
Reiko
R
Imai
Yoko
Y
Hagiwara
Tadashi
T
Kamada
Shin-Ichiro
S
Tatezaki
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002250:Carbon Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
D002250:Carbon Radioisotopes; D008558:Melphalan