Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
12
|
| pubmed:dateCreated |
1998-2-12
|
| pubmed:abstractText |
Twenty-four high-risk Ewing's sarcoma patients were treatedf on an intensive combined modality protocol including low-dose fractionated total body irradiation (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 patients with a single metastasis were again rendered disease-free and remain free from second relapse with 18 and 30 months follow-up. No other relapsed patient was able to be rendered disease-free, and most died of progressive disease within 6 to 12 months of relapse. Two patterns of granulocyte recovery following consolidative therapy (include TBI) and ABMI were recognized. Seventeen patients reached a total granulocyte count of >500 cells/mm3 within 4 weeks of ABMI (early graulocyte recovery), while seven patients required >4 weeks from ABMI (late granulocyte recovery). The time of platelet recovery (>50,000/mm3) was different for the groups with early and late granulocyte recovery (25 days vs. 54 days, p <.001). Six of seven patients with late granulocyte recovery received locl high-dose irratiation to >1/2 pelvis prior to bone marrow storage. Patients with late recovery did not tolerate maintenance chemotherapy. However, there was no difference in disease-free and overall survival, when compaing the groups with early and late granulocyte recovery. We conclude that these high-risk Ewing's sarcoma patients remain a poor-prognosis group in spite of intensive combined modality therapy include 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.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Dec
|
| pubmed:issn |
0360-3016
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
9
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1955-60
|
| pubmed:dateRevised |
2011-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:9463099-Adolescent,
pubmed-meshheading:9463099-Adult,
pubmed-meshheading:9463099-Agranulocytosis,
pubmed-meshheading:9463099-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:9463099-Bone Marrow Transplantation,
pubmed-meshheading:9463099-Bone Neoplasms,
pubmed-meshheading:9463099-Child,
pubmed-meshheading:9463099-Combined Modality Therapy,
pubmed-meshheading:9463099-Cyclophosphamide,
pubmed-meshheading:9463099-Dactinomycin,
pubmed-meshheading:9463099-Disease-Free Survival,
pubmed-meshheading:9463099-Female,
pubmed-meshheading:9463099-Humans,
pubmed-meshheading:9463099-Lung Neoplasms,
pubmed-meshheading:9463099-Male,
pubmed-meshheading:9463099-Neoplasm Recurrence, Local,
pubmed-meshheading:9463099-Sarcoma, Ewing,
pubmed-meshheading:9463099-Vincristine,
pubmed-meshheading:9463099-Whole-Body Irradiation
|
| pubmed:year |
1983
|
| pubmed:articleTitle |
Intensive combined modality therapy including low-dose TBI in high-risk Ewing's Sarcoma Patients.
|
| pubmed:affiliation |
Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|