title: Etoposide and carbo-or cisplatin combination therapy in refractory or relapsed Ewing sarcoma: a large retrospective study.
abstract: BACKGROUND
  Patients with Ewing sarcoma (EWS) who develop refractory or relapsed disease have limited treatment options. In some sarcoma centres in Europe the combination of etoposide with carbo- or cisplatin is being used for these patients, however, there are no published data available yet. Here we investigated the outcome of the combination treatment for patients with advanced Ewing sarcoma in progression after standard treatment.
  
  
  METHODS
  All patients diagnosed with EWS between 1980 and 2012 in one of six major sarcoma centres in Europe and treated with either carboplatin and etoposide or cisplatin and etoposide were included and data were retrospectively collected for analysis.
  
  
  RESULTS
  A total of 107 patients enrolled in this study of which 61 received the combination of etoposide and carboplatin and 46 received etoposide and cisplatin. The median overall survival (OS) was 23 months for both patient groups and the 5-year OS was 24.5% for the patients who received carboplatin and etoposide and 20% for those who received cisplatin and etoposide. The progression free survival was better in patients treated with the combination of carboplatin and etoposide (14.5 vs. 6.3 months P = 0.023).
  
  
  CONCLUSIONS
  This is a retrospective study on the combination treatment of etoposide and carbo- or cisplatin in refractory Ewing sarcoma. The results justify exploring the combination in a prospective study with relapsed patients.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Annemiek M
authors.initials: AM
authors.lastname: van Maldegem
authors.forename: Charlotte
authors.initials: C
authors.lastname: Benson
authors.forename: Piotr
authors.initials: P
authors.lastname: Rutkowski
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Henk
authors.initials: H
authors.lastname: van den Berg
authors.forename: Joanna
authors.initials: J
authors.lastname: Placzke
authors.forename: Meybrit
authors.initials: M
authors.lastname: Rasper
authors.forename: Ian
authors.initials: I
authors.lastname: Judson
authors.forename: Heribert
authors.initials: H
authors.lastname: Juergens
authors.forename: Uta
authors.initials: U
authors.lastname: Dirksen
authors.forename: Hans
authors.initials: H
authors.lastname: Gelderblom
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D055815:Young Adult
chemical_list: D005047:Etoposide; D016190:Carboplatin; D002945:Cisplatin
keywords: Ewing sarcoma; etoposide; outcome; platinum; prognostic factor; retrospective