1202 High-dose chemotherapy (HDC) with stemcell rescue for patients with metastatic Ewing's sarcoma

Abstract

Metastatic Ewing's sarcoma has generally a fatal outcome. Patients with bone metastases cannot be cured by conventional treatment and only 10% of patients with pulmonary disease have a considerable diseasefree survival (DFS). From 1990 six patients with metastatic Ewing's sarcoma have been treated in Leiden Univ. Hospital with HDC, followed by either bone marrow and/or peripheral stemcell rescue (SCR). Three of them suffered from recurrent Ewing's sarcoma, the other three had metastases at primary presentation. Pat. characteristics: 5 × male, one female. Mean age: 23 yrs. Localisation of primary tumor: rib 1 ×, vertebra 1 ×, scapula 2 ×, pelvis 2×. Metastases: bone 2×, lung 4×, lhn 2×. Induction treatment: VP16-Ifosfamide 4×, CDDP 2×. HDC: VP-16, Melphalan, Carboplatin 4×, VP-16-Melphalan 2×. TBI 1 ×. Four patients got 2 cycles of HDC; bone lesions were irradiated. Results mean PFS 9+ months (3–20+). Overall survival: 12+ months (6–26+). Conclusion HDC with bone marrow and/or peripheral SCR is still an experimental treatment. Although toxicity is substantial some patients do have a relative long DFS.