Researchers affiliated with the Children’s Oncology Group (COG) have reported that chemotherapy given every two weeks is more effective than chemotherapy given every three weeks in patients with localized Ewing’s Sarcoma. The details of this study were presented at the 2008 meeting of the American Society of Clinical Oncology in Chicago, May 30-June 2.¹

Localized Ewing’s sarcoma affects only bone in which it developed and adjacent tissues, such as muscle and tendon, with no distant metastases. Therapy is surgery or radiation therapy plus adjuvant chemotherapy. A previous study from Memorial-Sloan Kettering Cancer Center showed improved survival in patients with localized Ewing’s sarcoma who were treated with intensive neoadjuvant and adjuvant therapy.² The administration of chemotherapy every two weeks for patients with lymphoma and breast cancer has been more effective than every three weeks; this approach is known as dose-dense therapy.

The current study randomly allocated 568 patients with localized Ewing’s sarcoma to receive a regimen of vincristine, doxorubicin alternating with cyclophosphamide, ifosfamide, and etopside on an every two- or three-week schedule. Filgrastim was given with all cycles of therapy. The total number of cycles of chemotherapy administered was 14. Surgery or radiation therapy was carried out after four cycles of therapy on the three-week regimen and after six cycles of the every 14-day schedule. The following table summarizes the main findings of this trial:

There were no differences in side effects between the two regimens.

Comments: It would appear from this data that neoadjuvant and adjuvant chemotherapy given every two weeks is the standard of care for patients with localized Ewing’s sarcoma.

Related News:

Outcomes of Older Patients with Localized Ewing’s Sarcoma Similar to Younger Patients (2/16/2007)

ICE Plus CAV Intensification Promising for High Risk Ewing’s Sarcoma (3/31/2006)

Localized Pelvic Ewing Sarcoma has a Worse Prognosis Than Localized Involvement of Other Bones (2/20/2003)

Reference:

¹ Womer RB, West M, Krailo D, et al. Randomized comparison of every-two-week v. every-three week chemotherapy in Ewing sarcoma family tumors (ESFT). Journal of Clinical Oncology. 2008;26:abstract no. 10504.

² Kolb EA, Kushner BH, Gorlick R, et al. Long-term event-free survival after intensive chemotherapy for Ewing’s family of tumors in children and young adults. Journal of Clinical Oncology. 2003;3423-3420.