Ifosfamide and actinomycin-D, added in the induction phase to vincristine, cyclophosphamide and doxorubicin, improve histologic response and prognosis in patients with non metastatic Ewing's sarcoma of the extremity
Ifosfamide and actinomycin-D, added in the induction phase to vincristine, cyclophosphamide and doxorubicin, improve histologic response and prognosis in patients with non metastatic Ewing's sarcoma of the extremity
复制标题
DOI：
10.1179/joc.1998.10.6.484
复制
发表时间：
1998-12-01
影响因子：
1.8
通讯作者：
Bacci, G
中科院分区：
文献类型：
--
作者：
Ferrari, S;Mercuri, M;Bacci, G
异环磷酰胺作为四肢非转移性尤文肉瘤一线化疗的作用仍在讨论中。本文的目的是报告从诱导期开始，在传统的VacA方案的基础上加入异环磷酰胺的新辅助方案(任-S)取得的结果。诱导化疗包括长春新碱、环磷酰胺、阿霉素、放线菌素-D和异环磷酰胺。在局部治疗后，患者接受诱导期使用的药物和依托泊苷。1991年11月至1994年11月，共收治肢体非转移性尤文肉瘤61例。49例患者接受了手术治疗，其中73.5%的患者组织学反应良好。平均随访60个月(范围32-76个月)，48名患者(79%)持续无病。5年无事件生存率和总生存率分别为77%和87%。这些结果在组织学反应或无事件和总存活率方面都明显好于58例四肢非转移性尤文氏肉瘤患者，在此之前的方案(REN-2)中，使用相同的药物，但异环磷酰胺只在维持期使用。本研究提示早期应用异环磷酰胺治疗四肢非转移性尤文肉瘤的重要性。
The role of ifosfamide as first-line chemotherapy treatment of non metastatic Ewing's sarcoma of the extremity is still under discussion. The purpose of this paper is to report the results achieved in a neoadjuvant protocol (REN-S) in which ifosfamide, added to the conventional VACA regimen, was employed since the induction phase. Induction chemotherapy consisted of vincristine, cyclophosphamide, doxorubicin, actinomycin-D and ifosfamide. After local treatment, patients received the drugs used in the induction phase and etoposide. Between November 1991 and November 1994, 61 patients with non metastatic Ewing's sarcoma of the extremity were treated. Forty-nine patients underwent surgery and 73.5% of them had a good histologic response. At a median follow-up of 60 months (range 32-76), 48 patients (79%) remained continuously disease-free. The 5-year event-free and overall survival were 77% and 87%, respectively. These results were significantly better both in terms of histologic response or event-free and overall survival than those obtained in 58 patients with non metastatic Ewing's sarcoma of the extremity treated in a previous protocol (REN-2) in which the same drugs were used, but ifosfamide was employed only in the maintenance phase. The present study suggests the importance of early use of ifosfamide in the treatment of patients with non metastatic Ewing's sarcoma of the extremity.