Adjuvant chemotherapy in the treatment of clinically localised Ewing's sarcoma.

The results are presented of thirty-seven patients with Ewing's sarcoma; ten were treated by a combination of operation, radiotherapy and cyclic chemotherapy, the remainder by radiotherapy and chemotherapy but without operation. The drugs, vincristine, cyclophosphamide and adriamycin were used in combination and were continued for two years. The follow-up ranged from twelve to sixty-two months. The mortality rate and the incidence of metastases were both markedly lower than in a comparable previous series treated by radiotherapy alone, or by operation plus radiotherapy, but all without chemotherapy. The percentage of local recurrences and of metastases was much higher in the twenty-seven patients who had radiotherapy and adjuvant chemotherapy, than in the ten in whom operation was also performed. It is suggested that on the basis of these results (and on theoretical grounds) treatment should consist of radiotherapy combined with chemotherapy plus, whenever feasible, operative excision of the primary tumour.

Adjuvant chemotherapy associated with surgery in the treatment of osteosarcoma. Preliminary results.

The results are presented of thirty five cases of osteosarcoma in which radical surgery was associated with cyclic chemotherapy with vincrystin, adriamycin and methotrexate. Nine patients had pulmonary metastases at intervals of from three to twenty one months after operation; of these, seven died between six and twenty six months after operation. The remaining twenty six patients are in good health and show no signs of disease at follow up varying from twelve to forty eight months. The mortality rate and the percentage of patients with pulmonary metastase from six to forty eight months after operation are notably lower than in a previous series treated by surgery only.

[The association of local radiation therapy and systemic chemotherapy in the treatment of clinically localized Ewing's sarcoma]. / L'associazione terapia radiante locale - chemioterapia sistemica nel trattamento del sarcoma di Ewing clinicamente localizzato

The results obtained in 12 cases of still clinically localized Ewing's sarcoma by associating radiation therapy of the primary focus with intermittent systematic chemotherapy are reported. Two of these patients presented pulmonary and bone metastases 12 and 14 months respectively after bioptic diagnosis while the remaining ten were in good health and free from metastasis at between 6 and 28 months (average 16 months) after biopsy. Although it is considered necessary to make further observations before the association's validity is certain, it is considered that on this basis and on the basis of the few cases reported in the literature than the association of rationally conducted systematic chemotherapy with local radiation therapy will extend the onset time of metastasis and so increase average survival in Ewing's sarcoma.