Sluga M, Windhager R, Lang S, Heinzl H, Krepler P, Mittermayer F, Dominkus M, Zoubek A, Kotz R
Department of Orthopaedics, University of Vienna, Vienna, Austria.
Eur J Surg Oncol. 2001 Sep;27(6):569-73. doi: 10.1053/ejso.2001.1164.
The treatment of patients suffering from Ewing's sarcoma has changed over the last three decades. We report the analyses, significant prognostic factors, interdisciplinary approach and development of therapy in one institution in Austria.
One hundred and forty-two patients treated for Ewing's sarcoma between 1949 and 1994 were reviewed. Median follow-up was 8.5 years. Fifty-six patients were treated between 1949 and 1980 (group 1), and 86 patients between 1981 and 1994 (group 2). Patients in group 1 were treated with polychemotherapy. Patients in group 2 were treated with a neoadjuvant CESS (Cooperative Ewing's Sarcoma Study) regimen. In group 1, 24 patients underwent biopsy only, 32 patients had a definitive operation, 48 patients received either radiation therapy only or additional radiation therapy compared with in group 2: 6, 80 and 44 cases, respectively.
Five-year overall survival (OS) increased from 27% to 57%. Significant prognostic factors for OS were pre-operative metastases (P=0.0001), tumour location (P=0.0048), type of chemotherapy (P=0.002) and response to chemotherapy (P=0.0004). Chemotherapy (P=0.037), tumour location (P=0.0017) and metastases at diagnosis (P=0.0025) were significant.
The most effective treatment of Ewing's sarcoma is chemotherapy.
在过去三十年中，尤因肉瘤患者的治疗方法发生了变化。我们报告了奥地利一家机构对尤因肉瘤患者的分析、重要预后因素、多学科治疗方法及治疗进展。
回顾了1949年至1994年间接受尤因肉瘤治疗的142例患者。中位随访时间为8.5年。1949年至1980年间治疗了56例患者（第1组），1981年至1994年间治疗了86例患者（第2组）。第1组患者接受多药化疗。第2组患者接受新辅助CESS（尤因肉瘤协作研究）方案治疗。在第1组中，24例患者仅接受活检，32例患者进行了根治性手术，48例患者仅接受放射治疗或额外接受放射治疗，而在第2组中，分别为6例、80例和44例。
五年总生存率（OS）从27%提高到了57%。OS的重要预后因素为术前转移（P=0.0001）、肿瘤位置（P=0.0048）、化疗类型（P=0.002）和化疗反应（P=0.0004）。化疗（P=0.037）、肿瘤位置（P=0.0017）和诊断时的转移情况（P=0.0025）具有显著性。
尤因肉瘤最有效的治疗方法是化疗。
