Nilbert M, Saeter G, Elomaa I, Monge O R, Wiebe T, Alvegård T A
Department of Oncology, University Hospital, Lund, Sweden.
Acta Oncol. 1998;37(4):375-8. doi: 10.1080/028418698430601.
A report on the long-term follow up of the first cooperative Scandinavian Sarcoma Group study in Ewing's sarcoma of bone is presented. Fifty-two previously untreated patients entered the study between 1984 and 1990. Half of the tumors were located in the extremities and one quarter in the pelvis. The combined modality treatment consisted of 5 cycles of chemotherapy--including vincristine, methotrexate, doxorubicin, cyclophosphamide, bleomycin and dactinomycin. The first two cycles were followed by local resection or amputation in 35 patients and by radiotherapy alone in 17 patients. When surgery was not performed, was incomplete or yielded poor margins radiotherapy was given at a dose of 40-60 Gy. Local tumor relapses developed in 10 patients and in all but one patient were accompanied by metastatic disease. Five patients had metastasis at diagnosis and distant metastases developed after primary treatment in 27 patients after a median of 14 months. The median follow-up time for the 20 surviving patients is 10 years. At 5 years the tumor-related survival was 46% and the metastasis-free survival 43%. Late tumor relapses occurred in 4 patients, which reduced the 10-year tumor related survival to 41% and the metastasis-free survival to 38%. Histopathological tumour response correlated with survival with 5-year metastasis-free survival rates of 73% for the good responders and 35% for the poor responders.
本文呈现了斯堪的纳维亚肉瘤协作组关于骨尤文肉瘤的第一项合作研究的长期随访报告。1984年至1990年间，52例未经治疗的患者进入该研究。一半的肿瘤位于四肢，四分之一位于骨盆。综合治疗方案包括5个周期的化疗，使用长春新碱、甲氨蝶呤、阿霉素、环磷酰胺、博来霉素和放线菌素。前两个周期后，35例患者接受了局部切除或截肢，17例患者仅接受了放疗。当未进行手术、手术不完整或切缘不佳时，给予40 - 60 Gy的放疗。10例患者出现局部肿瘤复发，除1例患者外，所有复发均伴有转移。5例患者在诊断时已有转移，27例患者在初次治疗后出现远处转移，中位时间为14个月。20例存活患者的中位随访时间为10年。5年时，肿瘤相关生存率为46%，无转移生存率为43%。4例患者出现晚期肿瘤复发，这使得10年肿瘤相关生存率降至41%，无转移生存率降至38%。组织病理学肿瘤反应与生存率相关，良好反应者5年无转移生存率为73%，不良反应者为35%。
