title: A Review of Ewing Sarcoma Treatment: Is it Still a Subject of Debate?
abstract: The Ewing sarcoma (ES) represents 10 to 15% malignant bone tumors and 40 to 45% pediatric malignant bone tumors. The aim of this review is to clarify the therapeutic results and prognostic factors of this entity.
  
  
  
  A systematic review of the literature was performed. Studies focused on the management of ES were considered for inclusion.
  
  
  
  ES represents a model of multidisciplinary approach. The optimization of ES multimodality therapeutic strategies has resulted from the efforts of several national and international groups in Europe and North America and from cooperation between the pediatric and medical oncologists. The overall 5- year survival of Ewing localized tumors was 70% versus 30% in metastatic ES.
  
  
  
  The treatment of ES includes neoadjuvant and adjuvant chemotherapies with surgery and/or radiotherapy for control of the primary site and possible metastatic disease. The role of high-dose chemotherapy is still debated.
authors.affiliation: Department of Oncology Habib Bourguiba Hospital, Sfax, Tunisia.
authors.forename: Wala Ben
authors.initials: WB
authors.lastname: Kridis
authors.forename: Nabil
authors.initials: N
authors.lastname: Toumi
authors.forename: Hadil
authors.initials: H
authors.lastname: Chaari
authors.forename: Afef
authors.initials: A
authors.lastname: Khanfir
authors.forename: Kamel
authors.initials: K
authors.lastname: Ayadi
authors.forename: Hassib
authors.initials: H
authors.lastname: Keskes
authors.forename: Tahia
authors.initials: T
authors.lastname: Boudawara
authors.forename: Jamel
authors.initials: J
authors.lastname: Daoud
authors.forename: Mounir
authors.initials: M
authors.lastname: Frikha
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D057285:Precision Medicine / Q000379:methods*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis
keywords: Chemotherapy; ewing sarcoma; malignant bone tumors; prognostic factor; therapeutic strategies; treatment