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Luksch R, Tienghi A, Hall KS, Fagioli F, Picci P, Barbieri E, Gandola L, Eriksson M, Ruggieri P, Daolio P, Lindholm P, Prete A, Bisogno G, Tamburini A, Grignani G, Abate ME, Podda M, Smeland S, Ferrari S. Primary metastatic Ewing's family tumors: results of the Italian Sarcoma Group and Scandinavian Sarcoma Group ISG/SSG IV Study including myeloablative chemotherapy and total-lung irradiation. Ann Oncol 2012; 23:2970-2976. [PMID: 22771824 DOI: 10.1093/annonc/mds117] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The Italian Sarcoma Group and the Scandinavian Sarcoma Group designed a joint study to improve the prognosis for patients with Ewing's family tumors and synchronous metastatic disease limited to the lungs, or the pleura, or a single bone. PATIENTS AND METHODS The study was opened in 1999 and closed to the enrollment in 2008. The program consisted of intensive five-drug combination chemotherapy, surgery and/or radiotherapy as local treatment, and consolidation treatment with high-dose busulfan/melphalan plus autologous stem cell rescue and total-lung irradiation. RESULTS During the study period, 102 consecutive patients were enrolled. The median follow-up was 62 months (range 24-124). The 5-year event-free survival probability was 0.43 [standard deviation (SD) = 0.05] and the 5-year overall survival probability was 0.52 (SD = 0.052). Unfavorable prognostic factors emerging on multivariate analysis were a poor histological/radiological response at the site of the primary tumor [relative risk (RR) = 3.4], and incomplete radiological remission of lung metastases after primary chemotherapy (RR = 2.6). One toxic death and one secondary leukemia were recorded. CONCLUSIONS This intensive approach is feasible and long-term survival is achievable in ∼50% of patients. New treatment approaches are warranted for patients responding poorly to primary chemotherapy.
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Affiliation(s)
- R Luksch
- Department of Pediatrics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan.
| | - A Tienghi
- Department of Oncology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - K Sundby Hall
- Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - F Fagioli
- Department of Pediatric Onco-Hematology, Regina Margherita Children's Hospital, Turin
| | - P Picci
- Department of Musculoskeletal Oncology, Experimental Oncology Division, Istituto Ortopedico Rizzoli, Bologna
| | - E Barbieri
- Department of Radiotherapy, University of Bologna, Policlinico Sant'Orsola, Bologna
| | - L Gandola
- Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Eriksson
- Skane Onkologiska Klinik, Lund University Hospital and Lund University, Lund, Sweden
| | - P Ruggieri
- Department of Musculoskeletal Oncology, Division of Surgery, Istituto Ortopedico Rizzoli, Bologna
| | - P Daolio
- Oncologic/Orthopedic Surgery, Istituto Ortopedico G. Pini, Milan, Italy
| | - P Lindholm
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - A Prete
- Department of Pediatric Oncology, University of Bologna, Policlinico Sant'Orsola, Bologna
| | - G Bisogno
- Department of Pediatric Oncology, University of Padua, Padua
| | - A Tamburini
- Department of Pediatric Onco-Hematology, Ospedale Meyer, Florence
| | - G Grignani
- Department of Medical Oncology, Institute for Cancer Research and Treatment, Candiolo
| | - M E Abate
- Department of Musculoskeletal Oncology, Division of Chemotherapy, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M Podda
- Department of Pediatrics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - S Smeland
- Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - S Ferrari
- Department of Musculoskeletal Oncology, Division of Chemotherapy, Istituto Ortopedico Rizzoli, Bologna, Italy
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Del Bianco S, Parafioriti A, Armiraglio E, Daolio P, Mapelli S. 9408 Synovial sarcoma: molecular characterization from paraffine- embedded samples. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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