Because of the high incidence of pulmonary and skeletal metastases after only local treatment adjuvant systemic chemotherapy is mandatory in Ewing's sarcoma. The drugs most often used thereby are Actinomycin D, Cyclophosphamid, Anthracyclines and Vincristine. In polychemotherapeutic trials two year disease-free survival rates of 80% and more have been accomplished. The rate of local tumour control after radiotherapy is enhanced by chemotherapy but untoward reactions of bone and soft tissue are also. The extent of radiation portals and time indispensable dose of radiation therefore have to be reviewed again. But in view of debilitating side effects of radio-chemotherapy surgical procedures have to be considered individually.