Graham-Pole J
Med Pediatr Oncol. 1979;7(1):1-8. doi: 10.1002/mpo.2950070102.
Twenty-one patients with pathologically proven Ewing sarcoma without overt metastases at diagnosis were treated with a protocol designed by the Royal Marsden/St. Bartholomew's Hospitals Children's Solid Tumour Group (CSTG). They received megavoltage radiotherapy to the involved bone and adjuvant chemotherapy with a combination of four cytotoxic drugs. Seven patients have so far relapsed, four at the original site and three in other bones. The other 14 are clinically free of disease a median of 36 months from diagnosis. Comparison with a historical control group of 19 patients treated with surgery or radiotherapy, but without initial chemotherapy, shows a significant improvement in survival for the study group (P = 0.03). Seventeen of the controls have died. The treatment regime was moderately toxic, but there were no treatment-related deaths. These results confirm that an improved survival time and hopefully cure rate can be expected from treating Ewing tumour with high doses of megavoltage radiation and combination chemotherapy. Future goals must be the better control of large primary lesions and the eradication of micrometastases in other bones. The place of surgery should be re-evaluated in the treatment of the primary tumour, and better adjuvant chemotherapy regimes are needed.
21例经病理证实诊断时无明显转移的尤因肉瘤患者，接受了由皇家马斯登医院/圣巴塞洛缪医院儿童实体瘤组（CSTG）设计的方案治疗。他们接受了对受累骨骼的兆伏级放疗以及四种细胞毒性药物联合的辅助化疗。到目前为止，7例患者复发，4例在原发部位，3例在其他骨骼。另外14例自诊断起中位36个月临床无病。与19例接受手术或放疗但未进行初始化疗的历史对照组相比，研究组的生存率有显著提高（P = 0.03）。对照组中有17例死亡。该治疗方案毒性中等，但无治疗相关死亡。这些结果证实，用高剂量兆伏级放疗和联合化疗治疗尤因肿瘤有望提高生存时间及治愈率。未来的目标必须是更好地控制大的原发病变并根除其他骨骼中的微小转移灶。在原发性肿瘤的治疗中应重新评估手术的地位，并且需要更好的辅助化疗方案。
