Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India.
Department of Radiation Oncology, Regional Cancer Centre, Trivandrum, Kerala, India.
J Cancer Res Ther. 2024 Jan 1;20(1):79-84. doi: 10.4103/jcrt.jcrt_775_22. Epub 2023 Apr 8.
Ewing's sarcoma (EWS) is an aggressive small round cell tumor, affecting bone and soft tissues and is mostly seen in childhood and second decade of life. EWS accounts for 10-12% of bone tumors in more than 15 years age group and is even rarer after 40 years of age.
This retrospective analysis was conducted among patients aged more than 15 years with histologically proven EWS.
Among 240 cases of EWS treated at our center during 2001-2010, 130 (54%) were more than 15 years of age. The median age was 20 years with a male: female ratio of 2.4:1. Ninety percent had skeletal EWS, 10% had extra skeletal EWS, and 37% patients were metastatic at presentation. Eighty-two received curative treatment with chemotherapy (vincristine, doxorubicin, cyclophosphamide, ifosfamide, etoposide (VAC/IE)) along with local treatment, radiotherapy (RT) in 61, surgery alone in seven, and RT plus surgery in 14. Two- and 5-year overall survival (OS) was 43.3% and 25.5%, respectively, for the entire series. The OS for the non-metastatic group was 63.2% at 2 years and 36.5% at 5 years, and the progression free survival was 53.7% at 2 years and 37.8% at 5 years. High lactate dehydrogenase was found to be a significant poor prognostic factor (P = 0.001). Median OS for localized central EWS was 49.2 months and that for peripheral EWS was 24 months. Patients more than 20 years of age with non-metastatic disease had better OS compared to those with 15-20 years of age.
Treatment of EWS requires a multidisciplinary approach with radical surgery and/or radiation to control local disease and multiagent chemotherapy to control systemic disease. Long-term follow-up is essential because of disease relapse and treatment-related complications.
尤因肉瘤（EWS）是一种侵袭性小圆细胞肿瘤，影响骨骼和软组织，主要见于儿童和生命的第二个十年。EWS 占 15 岁以上年龄组骨肿瘤的 10-12%，甚至在 40 岁以后更为罕见。
本回顾性分析在我们中心 2001-2010 年期间接受组织学证实的 EWS 治疗的年龄超过 15 岁的患者中进行。
在我们中心治疗的 240 例 EWS 患者中，有 130 例（54%）年龄超过 15 岁。中位年龄为 20 岁，男女比例为 2.4:1。90%为骨骼 EWS，10%为骨外 EWS，37%的患者在就诊时已有转移。82 例患者接受了以化疗（长春新碱、阿霉素、环磷酰胺、异环磷酰胺、依托泊苷（VAC/IE））联合局部治疗、放疗（RT）的根治性治疗，61 例、单独手术 7 例、RT 加手术 14 例。整个系列的 2 年和 5 年总生存率（OS）分别为 43.3%和 25.5%。无转移组的 2 年和 5 年 OS 分别为 63.2%和 36.5%，无进展生存率分别为 53.7%和 37.8%。高乳酸脱氢酶被发现是一个显著的不良预后因素（P = 0.001）。局限性中央 EWS 的中位 OS 为 49.2 个月，周围 EWS 为 24 个月。无转移疾病的年龄超过 20 岁的患者的 OS 优于年龄在 15-20 岁的患者。
EWS 的治疗需要多学科方法，包括根治性手术和/或放疗以控制局部疾病，以及多药化疗以控制全身疾病。由于疾病复发和治疗相关并发症，需要进行长期随访。
