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Impact of chemotherapy cycles and intervals on outcomes of nonspinal Ewing sarcoma in adults: a real-world experience

  • Zhang, Jianjun1
  • Huang, Yujing1
  • Sun, Yuanjue2
  • He, Aina1
  • Zhou, Yan1
  • Hu, Haiyan1
  • Yao, Yang1
  • Shen, Zan1
  • 1 Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Rd, Shanghai, 200233, China , Shanghai (China)
  • 2 Shanghai Jiao Tong University Affiliated Sixth People’s Hospital South Campus, 6600 Nanfeng Rd, Shanghai, 201499, China , Shanghai (China)
Published Article
BMC Cancer
Springer (Biomed Central Ltd.)
Publication Date
Dec 02, 2019
DOI: 10.1186/s12885-019-6407-5
Springer Nature


BackgroundAdult Ewing sarcoma (ES) is a rare disease, the optimal treatment model is unknown. This study aimed to retrospectively analyze treatment-related prognostic factors of nonspinal ES in Chinese adults.MethodsEighty-one patients treated between January 2005 and December 2017 were included in the present study. Thirty-three (40.7%) presented with metastatic disease at diagnosis. Eight patients were submitted to primary surgery followed by chemotherapy, while 73 patients received chemotherapy before and after surgery and/or local radiotherapy. The chemotherapy regimen included 8–17 cycles of vincristine, doxorubicin, and cyclophosphamide (VDC) alternating with ifosfamide and etoposide (IE) every 3 weeks. Clinical outcomes and safety were analyzed.ResultsVDC/IE chemotherapy was well tolerated in adult patients with ES. Multivariate Cox regression analyses revealed that chemotherapy of at least 12 cycles was a favorable independent prognostic factor of event-free survival (hazard ratio, 0.558; 95% confidence interval, 0.323–0.965; P = 0.037) and overall survival (hazard ratio, 0.424; 95% confidence interval, 0.240–0.748; P = 0.003). Similarly, a low frequency of chemotherapy delays was an independent prognostic factor of improved OS (hazard ratio, 0.438; 95% confidence interval, 0.217–0.887; P = 0.022).ConclusionOur study suggests that adults with ES should be treated with an aggressive multidisciplinary approach, intensive chemotherapy with adequate cycles and appropriate intervals can be recommended in this group.

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