Zandaki Dua'a, Ismael Taleb, Halalsheh Hadeel, Ibrahimi Ahmad K H, Sarhan Nasim, Ghandour Khalil, Shehadeh Ahmad, Sultan Iyad
Department of Pediatrics, King Hussein Cancer Center.
Department of Pediatrics, the University of Jordan, Amman, Jordan.
J Pediatr Hematol Oncol. 2023 Apr 1;45(3):111-115. doi: 10.1097/MPH.0000000000002478. Epub 2022 May 9.
Interval compression (IC), a regimen of alternating vincristine/doxorubicin/cyclophosphamide and ifosfamide/etoposide every 2 weeks, improves survival for localized Ewing sarcoma (ES), with uncertain effect on metastatic disease.
We reviewed the charts of pediatric patients with metastatic ES treated with IC at our center between January 2013 and March 2020. We calculated event-free survival and overall survival (OS) and used log-rank tests for univariate comparisons.
We identified 34 patients 2.7 to 17.1 years of age (median: 11.6 y). Twenty-six patients (76%) had pulmonary metastases, and 14 (41%) had extrapulmonary metastases. All patients received local control therapy: surgery only (n=7, 21%), radiotherapy only (n=18, 53%), or both (n=9, 26%). The estimated 3-year OS and event-free survival were 62%±9% and 39%±9%, respectively. Patients with pulmonary-only and extrapulmonary metastasis had a 3-year OS of 88%±8% and 27%±13%, respectively ( P =0.0074). Age group (above vs. below 12 y), or primary tumor site did not affect survival, but local control therapy did (surgery only, 83%±15%; combined surgery and radiation, 30%±18%; radiation only, 15%±10%; P =0.048).
IC yielded similar outcomes for patients with metastatic ES to other reported regimens. We suggest including this approach to other blocks of therapy.
间歇化疗（IC），即每2周交替使用长春新碱/阿霉素/环磷酰胺和异环磷酰胺/依托泊苷的方案，可提高局限性尤因肉瘤（ES）患者的生存率，对转移性疾病的疗效尚不确定。
我们回顾了2013年1月至2020年3月在我们中心接受IC治疗的转移性ES儿科患者的病历。我们计算了无事件生存率和总生存率（OS），并使用对数秩检验进行单因素比较。
我们确定了34例年龄在2.7至17.1岁之间（中位数：11.6岁）的患者。26例（76%）有肺转移，14例（41%）有肺外转移。所有患者均接受了局部控制治疗：仅手术（n = 7，21%）、仅放疗（n = 18，53%）或两者都有（n = 9，26%）。估计3年总生存率和无事件生存率分别为62%±9%和39%±9%。仅肺转移和肺外转移患者的3年总生存率分别为88%±8%和27%±13%（P = 0.0074）。年龄组（12岁以上与12岁以下）或原发肿瘤部位不影响生存率，但局部控制治疗有影响（仅手术，83%±15%；手术和放疗联合，30%±18%；仅放疗，15%±10%；P = 0.048）。
IC对转移性ES患者产生的结果与其他报道的方案相似。我们建议将这种方法纳入其他治疗方案中。
