Frank Judith Amalie, Ranft Andreas, Paulussen Michael, Juergens Heribert, Kruseova Jarmila, Bauer Sebastian, Niggli Felix, Reichardt Peter, Dirksen Uta
Department of Pediatric Hematology and Oncology, University Hospital Muenster, Westfalian Wilhelms University, Muenster, Germany.
Vestische Kinder- und Jugendklinik, Datteln, University Witten/Herdecke, Datteln, Germany.
Pediatr Blood Cancer. 2017 Oct;64(10). doi: 10.1002/pbc.26524. Epub 2017 Apr 24.
Euro-EWING 99 trial of the European Ewing tumor Working Initiative of National Groups (EE99) was an international phase III study in patients with Ewing sarcoma. The German Society of Pediatric Oncology and Hematology (GPOH) data center registered and followed patients with other diagnoses than Ewing sarcoma who were treated according to the EE99 protocol in an additional non-Ewing database.
Data of 27 patients with other diagnoses than Ewing sarcoma treated according to the EE99 protocol were analyzed. Patients had miscellaneous histologic diagnoses, the majority were diagnosed with sarcoma not otherwise specified (NOS) arising in bone and soft tissue (63%).
The median age at diagnosis was 16.9 years (range 4.5-41.4). Localized disease was diagnosed in 61.5% of the patients and 38.5% had distant metastases at time of primary diagnosis. The median follow-up time was 3.7 years (range 0.5-9.5). Patients with localized disease showed a 3-year event-free survival (EFS) of 68%, compared to 3-year EFS of 20% in patients with metastases (P = 0.042). Three-year EFS for patients with sarcoma NOS was 52%, patients with localized and metastatic disease showed 3-year EFS of 66 and 20%, respectively.
EFS in patients with other diagnoses than Ewing sarcoma treated according to EE99 was significantly higher in patients with localized than metastatic disease. Sarcomas of soft tissue and bone that cannot be classified to current diagnostic categories constitute a therapeutic challenge.
欧洲尤文氏肉瘤国家组织工作倡议(EE99)的欧洲尤文氏肉瘤试验是一项针对尤文氏肉瘤患者的国际III期研究。德国儿科肿瘤学和血液学协会(GPOH)数据中心在一个额外的非尤文氏数据库中登记并随访了根据EE99方案治疗的非尤文氏肉瘤其他诊断患者。
分析了27例根据EE99方案治疗的非尤文氏肉瘤其他诊断患者的数据。患者有多种组织学诊断,大多数被诊断为骨和软组织中未另作说明的肉瘤(NOS)(63%)。
诊断时的中位年龄为16.9岁(范围4.5 - 41.4岁)。61.5%的患者被诊断为局限性疾病,38.5%在初次诊断时有远处转移。中位随访时间为3.7年(范围0.5 - 9.5年)。局限性疾病患者的3年无事件生存率(EFS)为68%,而转移患者的3年EFS为20%(P = 0.042)。NOS肉瘤患者的3年EFS为52%,局限性和转移性疾病患者的3年EFS分别为66%和20%。
根据EE99治疗的非尤文氏肉瘤其他诊断患者中,局限性疾病患者的EFS显著高于转移性疾病患者。无法归类到当前诊断类别的软组织和骨肉瘤构成了治疗挑战。