Ewing Sarcoma Treatment
The treatment for Ewing Sarcoma typically consists of chemotherapy combined with surgery and/or radiation.
The primary chemotherapy regimen is known as VDC/IE. This chemo alternates between two combinations of drugs given every two to three weeks. The first drug combination includes Vincristine, Doxorubicin, and Cyclophosphamide. The second set of chemo agents includes a combination of Ifosfamide and Etoposide. Cyclophosphamide was approved for use in 1959, followed by Vincristine (1963), Doxorubicin (1974), Etoposide (1983) and finally Ifosfamide which was approved in 1987.
Surgery and/or radiation is often combined with Ewing Sarcoma chemotherapy. Tumors in the arms or leg can be removed while saving the limb. This surgery, called limb salvage, replaces the removed bone with a bone graft (a piece of bone from elsewhere in the body or another person) or an internal prosthesis (a bone shaped piece of metal of other material). Amputation, which is the removal of part or all of the limb, is also seen in Ewing Sarcoma treatment. Tumors and affected bone that can’t be removed surgically are often treated with radiation. In many cases, a combination of surgery and radiation is chosen to improve the long-term prognosis.
The overall five-year survival rate for a patient with Ewing Sarcoma is between 60-70%. The last major advance in treatment came twenty years ago with clinical trials demonstrating that five drugs were better than three and interval compression (every two- week cycles) were superior to conventional timing (every three-week cycles).