title: Survival and prognostic factors in adult patients with recurrent or refractory ewing sarcoma family tumours: a 13-years retrospective study in Turkey.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the results of treatment and prognostic factors in adult patients with recurrent or refractory Ewing's sarcoma family tumors (ESFT).
  
  
  METHODS
  We retrospectively evaluated treatment outcomes of 54 consecutive patients with ESFT (aged 15 years or more) with complete medical records, who were treated with multimodal therapies after recurrence at the Istanbul University, Institute of Oncology.
  
  
  RESULTS
  The commonly used chemotherapy regimens at relapse were ifosfamide and etoposide (IE), ifosfamide and etoposide plus carboplatin (ICE), and oral etoposide. The median progression-free survival and overall survival for the entire group were 6.3 (95% confidence interval, 3.08-9.60) and 8.6 (95% confidence interval CI, 4.7-12.4) months, respectively. Multivariate analysis using a Cox proportional hazards model showed that non-IE/ICE chemotherapy regimens (p=0.003, hazard ratio=2.38) and the presence extrapulmonary metastases (p=0.045, hazard ratio=2.15) were associated with worse overall survival.
  
  
  CONCLUSIONS
  In primary refractory or relapsed ESFT, the presence of extrapulmonary metastases and treatment with salvage regimens other than ifosfamide and etoposide and/or carboplatin correlate with a poor prognosis.
authors.affiliation: Division of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey. dr_ibrahim2000@yahoo.com.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yildiz
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
authors.forename: Meltem
authors.initials: M
authors.lastname: Ekenel
authors.forename: Emin
authors.initials: E
authors.lastname: Darendeliler
authors.forename: Sevil
authors.initials: S
authors.lastname: Bavbek
authors.forename: Fulya
authors.initials: F
authors.lastname: Agaoglu
authors.forename: Harzem
authors.initials: H
authors.lastname: Ozger
authors.forename: Levent
authors.initials: L
authors.lastname: Eralp
authors.forename: Bilge
authors.initials: B
authors.lastname: Bilgic
authors.forename: Mert
authors.initials: M
authors.lastname: Basaran
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D014421:Turkey; D055815:Young Adult
keywords: Adult Ewing sarcoma; relapse; salvage chemotherapy