Intensive combined modality therapy including low-dose TBI in high-risk Ewing's sarcoma patients

Journal Article · Thu Dec 01 04:00:00 EST 1983 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(83)90368-1· OSTI ID:5011978

Kinsella, T J; Glaubiger, D; Diesseroth, A; Makuch, R; Waller, B; Pizzo, P; Glatstein, E

Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late granulocyte recovery. Patients with late recovery did not tolerate maintenance chemotherapy. However, there was no difference in disease-free and overall survival, when comparing the groups with early and late granulocyte recovery. It is concluded that these high-risk Ewing's sarcoma patients remain a poor-prognosis group in spite of intensive combined modality therapy including low-dose TBI. The control of microscopic systemic disease remains the major challenge to improving the cure rate. A new combined modality protocol with high-dose 'therapeutic' TBI (800 rad/2 fractions) is being used and the protocol design is outlined.

• Research Organization: National Inst. of Health, Bethesda, MD
• OSTI ID: 5011978
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 9:12; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ALKYLATING AGENTS
ANIMAL TISSUES
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTINEOPLASTIC DRUGS
BODY
BONE MARROW
DISEASES
DOXORUBICIN
DRUGS
ELECTROMAGNETIC RADIATION
ENDOXAN
EVALUATION
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
GRAFTS
HARD X RADIATION
HEMATOPOIETIC SYSTEM
IMMUNOSUPPRESSIVE DRUGS
IONIZING RADIATIONS
IRRADIATION
LOW DOSE IRRADIATION
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATIONS
RADIOLOGY
RADIOTHERAPY
SARCOMAS
THERAPY
TISSUES
TRANSPLANTS
WHOLE-BODY IRRADIATION
X RADIATION