Resumen de High risk Ewing¿s sarcomas. Effectiveness and toxicity of a regimen designed for children and used in adults
Ángel Luis Guerrero Zotano, Angel Agustín Segura Huerta, Pedro López Tendero, José Alejandro Pérez Fidalgo, Joaquín Montalar Salcedo, Jorge Aparicio Urtasun
Introduction. Ewing¿s sarcoma is a highly malignant small round-cell tumor arising primarily from bone. Adults with this neoplasm have a poorer survival than that of children. The Spanish Society of Paediatric Oncology (SEOP) recommends that high-risk patients be treated with a combination of 5 different drugs (EVAIA schedule). The objective of this study is to evaluate response, overall survival, dose intensity and toxicity of the SSOP protocol in adult patients with high-risk Ewing¿s sarcoma.
Material and methods. Between 1997 and 2001, 16 adults with a histological diagnosis of high-risk Ewing¿s sarcoma were treated according to SEOP recommendations. Median age was 23 years (range: 15-42). Enneking staging system indicated 7 patients (44%) were II-B and 9 patients (56%) at stage III.
Results. The responses were: 12 complete responses (75%), 1 partial response (6%), 2 patients with stable disease and 1 disease progression. At the time of the present analysis, 6 patients (38%) were alive and free of disease, 1 (6%) was alive with disease and 9 patients had died (8 of them due to disease progression and 1 secondary to a second line chemotherapy administered after EVAIA). Median survival was 21 months (range: 9-67) and median time to progression was 14 months (range: 6-23).
Conclusions. EVAIA protocol is an aggressive regimen in which the most frequent toxicity is granulocytopenia and anaemia. In our experience no deaths were due to this protocol. The use of EVAIA in first-line therapy achieved 81% response rate with a high rate of long-term survival in this patient population with poor prognosis.
