Treatment of adult patients with Ewing's sarcoma: compliance with chemotherapy protocols & toxicity.

Orit Kaidar-Person, Nissim Haim, Gil Bar-Sela
Author Information
  1. Orit Kaidar-Person: Division of Oncology, Rambam-Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, POB 9602, 31096 Haifa, Israel.

Abstract

Data on treatment outcome of adult patients with Ewing's sarcoma family of tumors (ESFT) are scarce. In some reports, adults with ESFT were found to have a worse outcome than children. The aim of this study was to assess compliance with chemotherapy protocols and toxicity and to compare two adult age groups. A retrospective analysis of clinical records of adult patients (≥ 21 years) treated at our center for ESFT from January 2000 to June 2010 was performed. Data recorded included demographics, clinical features, and outcomes. Patients were divided into two groups: ≥ 40 years (Group A) and < 40 years (Group B). Twenty-two patients were included in the analysis, nine in Group A and 13 in Group B. Median age was 54 years in group A and 29 years in group B. Extra-osseous origin was diagnosed in 8/9 (89%) patients in group A and 8/13 (61%) patients in group B (P = 0.3). No significant differences between the two age groups regarding dose intensity, compliance with protocol, hematological and non-hematological toxicity, or overall survival were found. It was concluded that a multidisciplinary approach including multi-agent chemotherapy for a prolonged period of time is appropriate in adult patients with ESFT. Dose intensity of chemotherapy should be determined according to the patient's clinical status and comorbidities. Treatment protocols used in the pediatric population, including high-dose chemotherapy, should be adapted for the adult population.

References

  1. J Clin Oncol. 2010 Jul 10;28(20):3284-91 [PMID: 20547982]
  2. J Am Acad Orthop Surg. 2010 Feb;18(2):94-107 [PMID: 20118326]
  3. Acta Oncol. 2000;39(1):111-6 [PMID: 10752664]
  4. Am J Pathol. 1993 Nov;143(5):1294-300 [PMID: 8238248]
  5. Am J Clin Oncol. 1988 Dec;11(6):614-7 [PMID: 3189226]
  6. Semin Radiat Oncol. 2010 Jan;20(1):45-51 [PMID: 19959030]
  7. Ann Surg. 1999 Jul;230(1):79-86 [PMID: 10400040]
  8. J Clin Oncol. 2007 Apr 1;25(10):1176-82 [PMID: 17401006]
  9. Oncology. 1980;37(2):114-9 [PMID: 7360479]
  10. J Clin Oncol. 1997 Jul;15(7):2611-21 [PMID: 9215832]
  11. N Engl J Med. 1994 Aug 4;331(5):294-9 [PMID: 8022439]
  12. Arch Surg. 2003 Mar;138(3):281-5 [PMID: 12611575]
  13. Med Pediatr Oncol. 2003 May;40(5):276-87 [PMID: 12652615]
  14. N Engl J Med. 2003 Feb 20;348(8):694-701 [PMID: 12594313]
  15. J Clin Oncol. 2001 Mar 15;19(6):1818-29 [PMID: 11251014]
  16. Virchows Arch. 2010 Feb;456(2):193-9 [PMID: 19787372]
  17. Neth J Med. 2007 Apr;65(4):132-6 [PMID: 17452761]
  18. Cancer. 2007 Feb 15;109(4):780-6 [PMID: 17219445]
  19. Int J Radiat Oncol Biol Phys. 1991 Mar;20(3):389-95 [PMID: 1995522]
  20. Cancer. 1999 Aug 1;86(3):421-8 [PMID: 10430250]
  21. Tumori. 2008 Nov-Dec;94(6):809-12 [PMID: 19267097]
  22. J Clin Oncol. 1998 Dec;16(12):3736-43 [PMID: 9850016]
  23. Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):1140-5 [PMID: 18513886]
  24. Cancer. 2010 Apr 15;116(8):1964-73 [PMID: 20151425]
  25. Am J Clin Oncol. 2004 Oct;27(5):529-34 [PMID: 15596925]
  26. Clin Oncol (R Coll Radiol). 2010 Jun;22(5):374-81 [PMID: 20466282]
  27. J Clin Oncol. 2008 Sep 20;26(27):4385-93 [PMID: 18802150]
  28. J Clin Oncol. 1990 Sep;8(9):1514-24 [PMID: 2099751]
  29. J Clin Oncol. 1997 Apr;15(4):1553-9 [PMID: 9193352]

MeSH Term

Adult
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols
Bone Neoplasms
Female
Guideline Adherence
Humans
Male
Middle Aged
Retrospective Studies
Sarcoma, Ewing
Treatment Outcome
Young Adult

Word Cloud

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