Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Clin Transl Oncol. 2012 Apr;14(4):294-301. doi: 10.1007/s12094-012-0798-y.
The purpose of this study is to assess the outcome of patients with Ewing sarcoma (EWS) of the bone and to identify prognostic factors.
Seventy-seven patients younger than 18 years old, diagnosed with EWS of the bone between 1979 and 2009, were analysed retrospectively. Four different protocols of chemotherapy were used successively. Local treatment consisted of surgery (N=32), radiotherapy (N=20) and a combination of both (N=19).
The median age at diagnosis was 10 years old (range, 2-17) and the median follow-up for survivors 8.6 years (range, 1-18.8). Thirty-two relapses occurred (21 distant, 5 local and 6 both). The 2- and 5-year overall survival rates were 70% and 51%, respectively. Multivariate analysis showed four significant independent predictors for death: age ≥14 years old (HR: 5.06; p=0.019), lack of complete response (HR: 8.04; p<0.001), tumour volume ≥150 ml (HR: 2.21; p=0.045) and distant recurrences (HR: 1.45; p=0.001).
Outcome of EWS of bone is influenced by many clinical and treatment-correlated variables. Criteria to stratify patients should include all the variables that have shown prognostic significance. The development of novel therapies should target these high-risk groups.
本研究旨在评估骨尤文肉瘤（EWS）患者的治疗效果并识别预后因素。
回顾性分析 1979 年至 2009 年间诊断为骨尤文肉瘤的 77 例年龄小于 18 岁的患者。患者先后接受了 4 种不同的化疗方案治疗。局部治疗包括手术（N=32）、放疗（N=20）和两者联合治疗（N=19）。
诊断时的中位年龄为 10 岁（范围 2-17 岁），幸存者的中位随访时间为 8.6 年（范围 1-18.8 年）。32 例患者发生复发（21 例远处转移，5 例局部复发，6 例两者均有）。2 年和 5 年总生存率分别为 70%和 51%。多因素分析显示，4 个独立的预后因素与死亡显著相关：年龄≥14 岁（HR：5.06；p=0.019）、无完全缓解（HR：8.04；p<0.001）、肿瘤体积≥150ml（HR：2.21；p=0.045）和远处复发（HR：1.45；p=0.001）。
骨尤文肉瘤的治疗效果受多种临床和治疗相关因素的影响。分层患者的标准应包括所有具有预后意义的变量。新型治疗方法的开发应针对这些高危人群。
