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Burdach, S.* ; Thiel, U.* ; Schöniger, M.* ; Haase, R.* ; Wawer, A.* ; Nathrath, M. ; Kabisch, H.* ; Urban, C.* ; Laws, H.J.* ; Dirksen, U. ; Steinborn, M.* ; Dunst, J.* ; Jürgens, H.*

Total body MRI-governed involved compartment irradiation combined with high-dose chemotherapy and stem cell rescue improves long-term survival in Ewing tumor patients with multiple primary bone metastases.

Bone Marrow Transplant. 45, 483-489 (2010)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
We examined the role of total body magnetic resonance imaging (TB-MRI)-governed involved compartment irradiation (ICI) and high-dose chemotherapy (HDC), followed by stem cell rescue (SCR) in patients with high-risk Ewing tumors (ETs) with multiple primary bone metastases (high-risk ET-MBM). Eleven patients with high-risk ET-MBM receiving initial assessment of involved bones by TB-MRI were registered from 1995 to 2000 (group A). In all, 6 patients out of 11 had additional lung disease at initial diagnosis; all had multifocal bone disease with more than three bones involved. After systemic induction with etoposide, vincristine, adriamycin (doxorubicin), ifosfamide, and actinomycin D (EVAIA) or VAIA chemotherapy, ICI of all sites positive by TB-MRI was administered, followed by HDC and SCR. A second group matched for observation period and consisting of 26 patients with more than three involved bones at diagnosis was treated with the European Intergroup Cooperative Ewing Sarcoma Study-92 (EICESS-92) protocol (group B). These patients did not receive TB-MRI and consequently did not receive TB-MRI-governed ICI, or HDC and SCR. Survival in group A vs group B was 45 vs 8% at 5 years and 27 vs 8% at 10 years after diagnosis (log rank and Breslow: P<0.005). We conclude that TB-MRI-governed ICI followed by HDC and SCR in ET-MBM is feasible and warrants further evaluation in prospective studies.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords high-risk ewing tumor; high-dose chemotherapy; involved compartment irradiation; total body MRI
ISSN (print) / ISBN 0268-3369
e-ISSN 1476-5365
Journal Bone Marrow Transplantation
Quellenangaben Volume: 45, Issue: 3, Pages: 483-489 Article Number: , Supplement: ,
Publisher Nature Publishing Group
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) CCG Osteosarcoma (PATH-KOS)