Iyer R S, Rao S R, Gurjal A, Nair C N, Pai S K, Kurkure P A, Pande S C, Advani S H
Department of Medical Oncology, Tata Memorial Hospital, Bombay, India.
J Surg Oncol. 1993 Mar;52(3):188-92. doi: 10.1002/jso.2930520315.
Between 1984-1987, 50 patients with Ewing's sarcoma of the bone were entered on combined modality protocol at Tata Memorial Hospital. Protocol treatment involved induction therapy consisting of 6-week therapy with vincristine, Adriamycin (doxorubicin), and cyclophosphamide (VDC) followed by local radiotherapy 50 Gy to the involved bone. This was followed for six more cycles of VDC. Five patients had metastatic disease at presentation. Seventy-six percent (38/50) of patients had disease either at axial or proximal site. With a median follow-up of 48 months (range 14-87) 21 patients remained alive with disease-free survival of 38.0% +/- 2.5% at 5 years and overall survival of 36.0% +/- 2.6% at 5 years. Twenty-five patients relapsed with five patients developing local failure and four local and distant metastasis. Using Lee-Desu statistical methods, only response to therapy was a significant factor for survival. We conclude that more aggressive therapy with proper selection of local treatment modality including surgery and/or radiotherapy is required to produce more long-term survival in high-risk Ewing's sarcoma.
1984年至1987年间，50例骨尤文肉瘤患者在塔塔纪念医院接受了综合治疗方案。方案治疗包括诱导治疗，即采用长春新碱、阿霉素（多柔比星）和环磷酰胺（VDC）进行为期6周的治疗，随后对受累骨骼进行50 Gy的局部放疗。之后再进行6个周期的VDC治疗。5例患者初诊时已有转移性疾病。76%（38/50）的患者病变位于轴位或近端部位。中位随访48个月（范围14 - 87个月），21例患者存活，5年无病生存率为38.0%±2.5%，5年总生存率为36.0%±2.6%。25例患者复发，其中5例出现局部失败，4例出现局部和远处转移。采用Lee - Desu统计方法，只有对治疗的反应是生存的一个重要因素。我们得出结论，对于高危尤文肉瘤，需要采用更积极的治疗方法，并适当选择包括手术和/或放疗在内的局部治疗方式，以提高长期生存率。
