Definition of treatment strategy for children and adolescents with ewing sarcoma in primary pelvic bone injury

Introdaction.Ewing’s sarcoma of the pelvic bones in children and adolescents is a complex, poorly studied problem. This is explained by the rare occurrence of the tumor and its biological characteristics: aggressive course, a tendency to develop early hematogenous metastases and frequent relapses.

The objective: analysis of the results of treatment of 72 children and adolescents with localized and disseminated Ewing sarcoma with primary lesions of the pelvic bones was carried out.

Materials and methods.During the study, a retrospective and prospective analysis of the results of treatment of 72 children and adolescents with localized and disseminated Ewing sarcoma with primary lesions of the pelvic bones was carried out. The patients were divided into 3 clinical groups (Induction, High-dose chemotherapy, Polychemotherapy) depending on the treatment performed. The patients received treatment under the MMES-99 protocol.

Results.The overall 1-year survival rate of all 72 patients included in the study was 86,1 %, 3-year – 50,0 %, 5-year – 42,5 % and 10-year – 39,3 %; disease-free survival rate – 66,6; 43,9; 41,9 % and 38,3 % respectively. Our analysis of overall survival did not reveal statistically significant differences between the High-dose chemotherapy and Polychemotherapy groups (p= 0,83). There were also no statistically significant differences in relapse-free survival (p= 0,68).

Conclusion.Considering that the indicators of overall and relapse-free survival did not significantly differ when performing one or another type of consolidation (High-dose chemotherapy versus Polychemotherapy groups) in patients with a good antitumor effect achieved on induction, when choosing the type of consolidation, one should take into account the capabilities of the medical institution, the presence of experience and equipment for carrying out autologous transplantation, the desired total duration of therapy (with High-dose chemotherapy, it is significantly shorter), as well as the total cost of the program.