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Establishing long-term survival and cure in young patients with Ewing's sarcoma
This paper investigates the potential for long-term survivorship for young patients diagnosed with Ewing's sarcoma. Data are examined from two successive UKCCSG Ewing's Tumour studies (ET-1 and ET-2). Patients have been followed for up to 20 years. These studies had suggested that better 5...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Nature Publishing Group
2004
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409819/ https://www.ncbi.nlm.nih.gov/pubmed/15213720 http://dx.doi.org/10.1038/sj.bjc.6601955 |
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author | Weston, C L Douglas, C Craft, A W Lewis, I J Machin, D |
author_facet | Weston, C L Douglas, C Craft, A W Lewis, I J Machin, D |
author_sort | Weston, C L |
collection | PubMed |
description | This paper investigates the potential for long-term survivorship for young patients diagnosed with Ewing's sarcoma. Data are examined from two successive UKCCSG Ewing's Tumour studies (ET-1 and ET-2). Patients have been followed for up to 20 years. These studies had suggested that better 5-year survival with ET-2 over the earlier ET-1 was achieved by replacing cyclophosphamide by ifosfamide and increasing the dose of doxorubicin in a four-drug chemotherapy regimen. The updated hazard ratio, stratified for metastatic status at diagnosis, of 0.39 (95% confidence interval 0.12–0.61) confirmed the advantage of the ET-2 regimen in terms of overall survival. Cure models, based on the Weibull distribution, suggested that factors for long-term survival in addition to presence of metastases were age, primary site of tumour and study. Modelling identified the proportion cured with the ET-2 protocol as best at 70% in those who are under 10 years with a nonpelvic primary site and without metastatic disease. This contrasts to only 13% cure in those with the corresponding adverse prognostic indicators. Additionally, the risk of death remains greatest but relatively constant over the first 2 years postdiagnosis, and then declines to a lower but constant value for the next 3 years before reaching the ‘cure plateau’ at about 5 years. This investigation suggests that ‘cure’ is possible for patients with Ewing's sarcoma. This is established at approximately 5 years post diagnosis and the proportion cured depends on the presence of metastases, pelvic site and age at diagnosis. |
format | Text |
id | pubmed-2409819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2004 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-24098192009-09-10 Establishing long-term survival and cure in young patients with Ewing's sarcoma Weston, C L Douglas, C Craft, A W Lewis, I J Machin, D Br J Cancer Clinical This paper investigates the potential for long-term survivorship for young patients diagnosed with Ewing's sarcoma. Data are examined from two successive UKCCSG Ewing's Tumour studies (ET-1 and ET-2). Patients have been followed for up to 20 years. These studies had suggested that better 5-year survival with ET-2 over the earlier ET-1 was achieved by replacing cyclophosphamide by ifosfamide and increasing the dose of doxorubicin in a four-drug chemotherapy regimen. The updated hazard ratio, stratified for metastatic status at diagnosis, of 0.39 (95% confidence interval 0.12–0.61) confirmed the advantage of the ET-2 regimen in terms of overall survival. Cure models, based on the Weibull distribution, suggested that factors for long-term survival in addition to presence of metastases were age, primary site of tumour and study. Modelling identified the proportion cured with the ET-2 protocol as best at 70% in those who are under 10 years with a nonpelvic primary site and without metastatic disease. This contrasts to only 13% cure in those with the corresponding adverse prognostic indicators. Additionally, the risk of death remains greatest but relatively constant over the first 2 years postdiagnosis, and then declines to a lower but constant value for the next 3 years before reaching the ‘cure plateau’ at about 5 years. This investigation suggests that ‘cure’ is possible for patients with Ewing's sarcoma. This is established at approximately 5 years post diagnosis and the proportion cured depends on the presence of metastases, pelvic site and age at diagnosis. Nature Publishing Group 2004-07-19 2004-06-22 /pmc/articles/PMC2409819/ /pubmed/15213720 http://dx.doi.org/10.1038/sj.bjc.6601955 Text en Copyright © 2004 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Weston, C L Douglas, C Craft, A W Lewis, I J Machin, D Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title | Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title_full | Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title_fullStr | Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title_full_unstemmed | Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title_short | Establishing long-term survival and cure in young patients with Ewing's sarcoma |
title_sort | establishing long-term survival and cure in young patients with ewing's sarcoma |
topic | Clinical |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409819/ https://www.ncbi.nlm.nih.gov/pubmed/15213720 http://dx.doi.org/10.1038/sj.bjc.6601955 |
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