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Outcomes of Pediatric Patients with metastatic Ewing sarcoma treated with interval compression
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  • Dua'a Zandaki,
  • Taleb Ismael,
  • Hadeel Halalsheh,
  • Ahmad Ibrahimi,
  • Nasim Sarhan,
  • Khalil Ghandour,
  • Ahmad Shehadeh,
  • Iyad Sultan
Dua'a Zandaki
King Hussein Cancer Center

Corresponding Author:[email protected]

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Taleb Ismael
King Hussein Cancer Center
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Hadeel Halalsheh
King Hussein Cancer Center
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Ahmad Ibrahimi
King Hussein Cancer Center
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Nasim Sarhan
King Hussein Cancer Center
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Khalil Ghandour
King Hussein Cancer Center
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Ahmad Shehadeh
King Hussein Cancer Center
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Iyad Sultan
King Hussein Cancer Center
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Abstract

Background: Interval compression (IC), defined as 2 week-long cycles of alternating vincristine/doxorubicin/cyclophosphamide and ifosfamide/etoposide, improves survival for localized Ewing sarcoma. The outcomes of patients with metastatic disease treated with IC are uncertain. Methods: We retrospectively reviewed the charts of pediatric patients with metastatic Ewing sarcoma treated with IC at our center between January-2013 and March-2020. We calculated event-free survival and overall survival and used log rank tests for univariate comparisons. Results: We identified 34 patients aged 2.7–17.1 years (median,11.6 years). Twenty-six patients (76%) had pulmonary metastases, and 14 (41%) had extra-pulmonary metastases in the bone (n = 11), lymph nodes (n = 2), and intraspinal tissue (n = 1). All patients received local control therapy: surgery only (n = 7, 21%), radiotherapy only (n = 18, 53%), or both (n = 9, 26%). The estimated 3-year OS and EFS were 62%±9% and 39%±9%, respectively. Patients with pulmonary only metastasis had a 3-year OS of 88%±8% in comparison to those with extra-pulmonary metastasis of 27%±13% (P=0.0074). Survival did not differ according to age group (> vs < 12 years), metastasis site, or primary tumor site, but 3-year event-free survival significantly differed according to local control therapy (surgery only, 83% ± 15%; combined surgery and radiation, 30% ± 18%; radiation only, 15% ± 10%; P = .048). Conclusion: IC yielded similar outcomes for patients with metastatic Ewing sarcoma to that reported in the literature using other regimens. We suggest including this approach to other blocks of therapy
09 May 2022Published in Journal of Pediatric Hematology/Oncology volume Publish Ahead of Print. 10.1097/MPH.0000000000002478