Hayes F A, Thompson E I, Meyer W H, Kun L, Parham D, Rao B, Kumar M, Hancock M, Parvey L, Magill L
Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN 38101.
J Clin Oncol. 1989 Feb;7(2):208-13. doi: 10.1200/JCO.1989.7.2.208.
Fifty-two previously untreated patients with localized Ewing's sarcoma of bone were treated with nonintensive chemotherapy in combination with surgery or radiation therapy (RT). RT was delivered to limited volumes in a dose dependent on the initial response to induction chemotherapy (30 to 35 Gy v 50 to 55 Gy). Fifty of the 52 patients achieved complete or partial responses with induction chemotherapy, with one nonresponding patient rendered free of tumor with surgery. Fifty patients were evaluable for local control of tumor and overall response to protocol therapy. Seventeen relapses have occurred; three metastatic, four local plus metastatic, and ten local. Two factors predicted worse disease-free survival: high WBC count (P = .03) and size of primary tumor (P = .05). Of the 14 local recurrences, 12 occurred in 28 patients who presented with primary tumors greater than 8 cm in size while only two of 22 patients with lesions less than 8 cm had local recurrence. The Kaplan-Meier estimate of disease-free survival at 3 years is 82% for those with small lesions and 64% for those with larger lesions. Site of primary was of no prognostic value (P = .27). The 5-year survival estimate for all patients is 80% (median time on study, 3.3 years).
52例先前未经治疗的局限性骨尤文肉瘤患者接受了非强化化疗联合手术或放射治疗（RT）。根据诱导化疗的初始反应，以剂量依赖的方式对有限体积进行RT（30至35 Gy对50至55 Gy）。52例患者中有50例在诱导化疗后达到完全或部分缓解，1例无反应患者通过手术实现无瘤状态。50例患者可评估肿瘤的局部控制和对方案治疗的总体反应。已发生17例复发；3例为转移复发，4例为局部加转移复发，10例为局部复发。两个因素预示无病生存期较差：白细胞计数高（P = 0.03）和原发肿瘤大小（P = 0.05）。在14例局部复发中，12例发生在28例原发肿瘤大于8 cm的患者中，而22例病变小于8 cm的患者中只有2例发生局部复发。对于病变较小的患者，3年无病生存期的Kaplan-Meier估计为82%，对于病变较大的患者为64%。原发部位无预后价值（P = 0.27）。所有患者的5年生存估计为80%（研究中位时间为3.3年）。
