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22.03.2022 | Osteosarkom | Leitthema

Aktuelle Überlegungen zur System- und Lokaltherapie beim Ewing-Sarkom

verfasst von: Prof. Dr. med. Beate Timmermann, D. Andreou, U. Dirksen

Erschienen in: Die Onkologie | Ausgabe 7/2022

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Zusammenfassung

Hintergrund

Das Ewing-Sarkom (EWS) ist ein bösartiger Tumor des Knochen- und Weichteilgewebes. Bereits bei der Diagnosestellung weisen 25 % der Patienten Fernmetastasen auf. Die multimodale Therapie setzt sich aus einer chemotherapeutischen Induktionsphase mit darauffolgender chirurgischer und/oder radiotherapeutischer Lokaltherapie und einer anschließenden adjuvanten Chemotherapie zusammen.

Ergebnisse

Bei lokoregionärer Erkrankung wird derzeit eine Kombinationschemotherapie, bestehend aus den Substanzen Ifosfamid, Cyclophosphamid, Doxorubicin, Etoposid, Actinomycin D und Vincristin, als Standard angesehen. Bei ungünstigem histologischen Ansprechen auf eine konventionell dosierte Chemotherapie wird eine hochdosierte Chemotherapie mit Busulfan und Melphalan in Verbindung mit einer Stammzelltransplantation eingesetzt. Die Planung der Lokaltherapie ist geprägt von der Möglichkeit einer makroskopisch vollständigen, En-bloc-Resektion mit tumorfreien Resektionsrändern und der perioperativen Morbidität. Aktuell wird oftmals eine Kombination aus Operation und Bestrahlung der Tumorregion favorisiert. Dabei erfolgt die Bestrahlung unter Einsatz hochkonformaler Techniken, wie z. B. der Protonentherapie, die heute bereits breiter verfügbar ist und mit der vielversprechende Ergebnisse bei der Behandlung des EWS erreicht werden konnten. Im Fall einer Metastasierung kann eine konsequente Lokaltherapie die Behandlungsergebnisse verbessern.
Literatur
1.
Zurück zum Zitat Andreou D, Hardes J, Gosheger G et al (2015) Interdisciplinary diagnostic and treatment of bone sarcomas of the extremities and trunk. Handchir Mikrochir Plast Chir 47:90–99PubMed Andreou D, Hardes J, Gosheger G et al (2015) Interdisciplinary diagnostic and treatment of bone sarcomas of the extremities and trunk. Handchir Mikrochir Plast Chir 47:90–99PubMed
2.
Zurück zum Zitat Andreou D, Ranft A, Gosheger G et al (2020) Which factors are associated with local control and survival of patients with localized pelvic ewing’s sarcoma? A retrospective analysis of data from the Euro-EWING99 trial. Clin Orthop Relat Res 478:290–302PubMedCrossRef Andreou D, Ranft A, Gosheger G et al (2020) Which factors are associated with local control and survival of patients with localized pelvic ewing’s sarcoma? A retrospective analysis of data from the Euro-EWING99 trial. Clin Orthop Relat Res 478:290–302PubMedCrossRef
4.
Zurück zum Zitat Attia S, Bolejack V, Ganjoo KN, George S, Agulnik M, Rushing DA, Loggers ET, Livingston MB, Wright JA, Chawla SP, Okuno SH, Reinke DK, Riedel RF, Davis LE, Ryan CW, Maki RG (2017) A phase II trial of regorafenib (REGO) in patients (pts) with advanced Ewing sarcoma and related tumors (EWS) of soft tissue and bone: SARC024 trial results. J Clin Oncol 35:1CrossRef Attia S, Bolejack V, Ganjoo KN, George S, Agulnik M, Rushing DA, Loggers ET, Livingston MB, Wright JA, Chawla SP, Okuno SH, Reinke DK, Riedel RF, Davis LE, Ryan CW, Maki RG (2017) A phase II trial of regorafenib (REGO) in patients (pts) with advanced Ewing sarcoma and related tumors (EWS) of soft tissue and bone: SARC024 trial results. J Clin Oncol 35:1CrossRef
5.
Zurück zum Zitat Bedetti B, Wiebe K, Ranft A et al (2015) Local control in Ewing sarcoma of the chest wall: results of the EURO-EWING 99 trial. Ann Surg Oncol 22:2853–2859PubMedCrossRef Bedetti B, Wiebe K, Ranft A et al (2015) Local control in Ewing sarcoma of the chest wall: results of the EURO-EWING 99 trial. Ann Surg Oncol 22:2853–2859PubMedCrossRef
6.
Zurück zum Zitat Bölling T, Dirksen U, Ranft A et al (2009) Radiation toxicity following busulfan/melphalan high-dose chemotherapy in the EURO-EWING-99-trial: review of GPOH data. Strahlenther Onkol 185(2):21–22PubMedCrossRef Bölling T, Dirksen U, Ranft A et al (2009) Radiation toxicity following busulfan/melphalan high-dose chemotherapy in the EURO-EWING-99-trial: review of GPOH data. Strahlenther Onkol 185(2):21–22PubMedCrossRef
7.
Zurück zum Zitat Bosma SE, Cleven AHG, Dijkstra PDS (2019) Can navigation improve the ability to achieve tumor-free margins in pelvic and sacral primary bone sarcoma resections? A historically controlled study. Clin Orthop Relat Res 477:1548–1559PubMedPubMedCentralCrossRef Bosma SE, Cleven AHG, Dijkstra PDS (2019) Can navigation improve the ability to achieve tumor-free margins in pelvic and sacral primary bone sarcoma resections? A historically controlled study. Clin Orthop Relat Res 477:1548–1559PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Bosma SE, Rueten-Budde AJ, Lancia C et al (2019) Individual risk evaluation for local recurrence and distant metastasis in Ewing sarcoma: a multistate model: a multistate model for ewing sarcoma. Pediatr Blood Cancer 66:e27943PubMedCrossRef Bosma SE, Rueten-Budde AJ, Lancia C et al (2019) Individual risk evaluation for local recurrence and distant metastasis in Ewing sarcoma: a multistate model: a multistate model for ewing sarcoma. Pediatr Blood Cancer 66:e27943PubMedCrossRef
9.
Zurück zum Zitat Brennan B, Kirton L, Marec-Berard P, Martin-Broto J, Gelderblom H, Gaspar N, Strauss SJ, Urgelles AS, Anderton J, Laurence V, Whelan J, Wheatley K (2020) Comparison of two chemotherapy regimens in Ewing sarcoma (ES): overall and subgroup results of the Euro Ewing 2012 randomized trial (EE2012). J Clin Oncol 38:1CrossRef Brennan B, Kirton L, Marec-Berard P, Martin-Broto J, Gelderblom H, Gaspar N, Strauss SJ, Urgelles AS, Anderton J, Laurence V, Whelan J, Wheatley K (2020) Comparison of two chemotherapy regimens in Ewing sarcoma (ES): overall and subgroup results of the Euro Ewing 2012 randomized trial (EE2012). J Clin Oncol 38:1CrossRef
10.
Zurück zum Zitat Burgert EO Jr., Nesbit ME, Garnsey LA et al (1990) Multimodal therapy for the management of nonpelvic, localized Ewing’s sarcoma of bone: intergroup study IESS-II. J Clin Oncol 8:1514–1524PubMedCrossRef Burgert EO Jr., Nesbit ME, Garnsey LA et al (1990) Multimodal therapy for the management of nonpelvic, localized Ewing’s sarcoma of bone: intergroup study IESS-II. J Clin Oncol 8:1514–1524PubMedCrossRef
11.
Zurück zum Zitat Chan RC, Sutow WW, Lindberg RD et al (1979) Management and results of localized Ewing’s sarcoma. Cancer 43:1001–1006PubMedCrossRef Chan RC, Sutow WW, Lindberg RD et al (1979) Management and results of localized Ewing’s sarcoma. Cancer 43:1001–1006PubMedCrossRef
12.
Zurück zum Zitat Choy E, Butrynski JE, Harmon DC et al (2014) Phase II study of olaparib in patients with refractory Ewing sarcoma following failure of standard chemotherapy. BMC Cancer 14:813PubMedPubMedCentralCrossRef Choy E, Butrynski JE, Harmon DC et al (2014) Phase II study of olaparib in patients with refractory Ewing sarcoma following failure of standard chemotherapy. BMC Cancer 14:813PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat Craft AW, Cotterill SJ, Bullimore JA et al (1997) Long-term results from the first UKCCSG Ewing’s tumour study (ET-1). United Kingdom children’s cancer study group (UKCCSG) and the medical research council bone sarcoma working party. Eur J Cancer 33:1061–1069PubMedCrossRef Craft AW, Cotterill SJ, Bullimore JA et al (1997) Long-term results from the first UKCCSG Ewing’s tumour study (ET-1). United Kingdom children’s cancer study group (UKCCSG) and the medical research council bone sarcoma working party. Eur J Cancer 33:1061–1069PubMedCrossRef
14.
Zurück zum Zitat Delaney TF, Trofimov AV, Engelsman M et al (2005) Advanced-technology radiation therapy in the management of bone and soft tissue sarcomas. Cancer Control 12:27–35PubMedCrossRef Delaney TF, Trofimov AV, Engelsman M et al (2005) Advanced-technology radiation therapy in the management of bone and soft tissue sarcomas. Cancer Control 12:27–35PubMedCrossRef
15.
Zurück zum Zitat Dirksen U, Brennan B, Le Deley MC et al (2019) High-dose chemotherapy compared with standard chemotherapy and lung radiation in ewing sarcoma with pulmonary metastases: results of the European ewing tumour working initiative of national groups, 99 trial and EWING 2008. J Clin Oncol 37:3192–3202PubMedPubMedCentralCrossRef Dirksen U, Brennan B, Le Deley MC et al (2019) High-dose chemotherapy compared with standard chemotherapy and lung radiation in ewing sarcoma with pulmonary metastases: results of the European ewing tumour working initiative of national groups, 99 trial and EWING 2008. J Clin Oncol 37:3192–3202PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Dirksen U, Bhadri V, Brichard B, Butterfass-Bahloul T, Cyprova S, Faldum A, Gelderblom H, Hardes J, Hauser P, Havemann L, Hjorth L, Juergens H, Kanerva J, Kuehne T, Ladenstein RL, Raciborska A, Rascon J, Timmermann B, Ranft A, Koch R (2020) Efficacy of add-on treosulfan and melphalan high-dose therapy in patients with high-risk metastatic Ewing sarcoma: report from the international Ewing 2008R3 trial. J Clin Oncol 38:1 Dirksen U, Bhadri V, Brichard B, Butterfass-Bahloul T, Cyprova S, Faldum A, Gelderblom H, Hardes J, Hauser P, Havemann L, Hjorth L, Juergens H, Kanerva J, Kuehne T, Ladenstein RL, Raciborska A, Rascon J, Timmermann B, Ranft A, Koch R (2020) Efficacy of add-on treosulfan and melphalan high-dose therapy in patients with high-risk metastatic Ewing sarcoma: report from the international Ewing 2008R3 trial. J Clin Oncol 38:1
17.
Zurück zum Zitat Dirksen U, Brennan B, Judson IR, Bernstein ML, Gorlick RG, Marina N, Womer RB, Cozic N, Gaspar N, Le Teuff G, Marec-Berard P, Faldum A, Paulussen M, Juergens H, Hjorth L, Wheatley K, Krailo MD, Whelan J, Hawkins DS (2016) Efficacy of busulfan-melphalan high dose chemotherapy consolidation (BuMel) compared to conventional chemotherapy combined with lung irradiation in ewing sarcoma (ES) with primary lung metastases: Results of EURO-EWING 99-R2pulm randomized trial (EE99R2pul). J Clin Oncol 34:1CrossRef Dirksen U, Brennan B, Judson IR, Bernstein ML, Gorlick RG, Marina N, Womer RB, Cozic N, Gaspar N, Le Teuff G, Marec-Berard P, Faldum A, Paulussen M, Juergens H, Hjorth L, Wheatley K, Krailo MD, Whelan J, Hawkins DS (2016) Efficacy of busulfan-melphalan high dose chemotherapy consolidation (BuMel) compared to conventional chemotherapy combined with lung irradiation in ewing sarcoma (ES) with primary lung metastases: Results of EURO-EWING 99-R2pulm randomized trial (EE99R2pul). J Clin Oncol 34:1CrossRef
18.
Zurück zum Zitat Dirksen U, Ranft A, Baumhoer D, van den Berg H, Brichard B, Eich HT, Gelderblom H, Hardes J, Hartmann W, Juergens H, Kollar A, Kruseova J, Kuehne T, Ladenstein RL, Leithner A, Streitbuerger A, Timmermann B, Tunn PU, Adreou D (2021) Association of treatment delays with an unfavorable outcome in patients with localized Ewing sarcoma: a retrospective analysis of data from the GPOH Euro‑E.W.I.N.G. 99 trial. J Clin Oncol 39:1CrossRef Dirksen U, Ranft A, Baumhoer D, van den Berg H, Brichard B, Eich HT, Gelderblom H, Hardes J, Hartmann W, Juergens H, Kollar A, Kruseova J, Kuehne T, Ladenstein RL, Leithner A, Streitbuerger A, Timmermann B, Tunn PU, Adreou D (2021) Association of treatment delays with an unfavorable outcome in patients with localized Ewing sarcoma: a retrospective analysis of data from the GPOH Euro‑E.W.I.N.G. 99 trial. J Clin Oncol 39:1CrossRef
19.
Zurück zum Zitat Dubois S, Buxton A, Laack N, Randall L, Chen H, Seibel N, Terezakis S, Hill-Kayser C, Hayes-Jordan A, Reid J, Teot L, Rakheja D et al (2019) Randomized phase 3 trial of ganitumab added to interval compressed chemotherapy for patients with newly diagnosed metastatic ewing sarcoma: a report from the children’s oncology group (cog). Connective Tissue Oncology Society (CTOS), Dubois S, Buxton A, Laack N, Randall L, Chen H, Seibel N, Terezakis S, Hill-Kayser C, Hayes-Jordan A, Reid J, Teot L, Rakheja D et al (2019) Randomized phase 3 trial of ganitumab added to interval compressed chemotherapy for patients with newly diagnosed metastatic ewing sarcoma: a report from the children’s oncology group (cog). Connective Tissue Oncology Society (CTOS),
20.
Zurück zum Zitat Dunst J, Schuck A (2004) Role of radiotherapy in Ewing tumors. Pediatr Blood Cancer 42:465–470PubMedCrossRef Dunst J, Schuck A (2004) Role of radiotherapy in Ewing tumors. Pediatr Blood Cancer 42:465–470PubMedCrossRef
21.
Zurück zum Zitat Elghazawy H, Nasr A, Zaky I et al (2020) Whole lung irradiation for completely responding pulmonary metastases in pediatric Ewing sarcoma. Future Oncol 16:1043–1051PubMedCrossRef Elghazawy H, Nasr A, Zaky I et al (2020) Whole lung irradiation for completely responding pulmonary metastases in pediatric Ewing sarcoma. Future Oncol 16:1043–1051PubMedCrossRef
22.
Zurück zum Zitat Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 60:731–746PubMedCrossRef Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 60:731–746PubMedCrossRef
23.
Zurück zum Zitat Evans RG, Nesbit ME, Gehan EA et al (1991) Multimodal therapy for the management of localized Ewing’s sarcoma of pelvic and sacral bones: a report from the second intergroup study. J Clin Oncol 9:1173–1180PubMedCrossRef Evans RG, Nesbit ME, Gehan EA et al (1991) Multimodal therapy for the management of localized Ewing’s sarcoma of pelvic and sacral bones: a report from the second intergroup study. J Clin Oncol 9:1173–1180PubMedCrossRef
24.
Zurück zum Zitat Federico SM, Pappo AS, Sahr N et al (2020) A phase I trial of talazoparib and irinotecan with and without temozolomide in children and young adults with recurrent or refractory solid malignancies. Eur J Cancer 137:204–213PubMedCrossRef Federico SM, Pappo AS, Sahr N et al (2020) A phase I trial of talazoparib and irinotecan with and without temozolomide in children and young adults with recurrent or refractory solid malignancies. Eur J Cancer 137:204–213PubMedCrossRef
25.
Zurück zum Zitat Foulon S, Brennan B, Gaspar N et al (2016) Can postoperative radiotherapy be omitted in localised standard-risk Ewing sarcoma? An observational study of the Euro‑E.W.I.N.G group. Eur J Cancer 61:128–136PubMedCrossRef Foulon S, Brennan B, Gaspar N et al (2016) Can postoperative radiotherapy be omitted in localised standard-risk Ewing sarcoma? An observational study of the Euro‑E.W.I.N.G group. Eur J Cancer 61:128–136PubMedCrossRef
26.
Zurück zum Zitat Gaspar N, Hawkins DS, Dirksen U et al (2015) Ewing sarcoma: current management and future approaches through collaboration. J Clin Oncol 33:3036–3046PubMedCrossRef Gaspar N, Hawkins DS, Dirksen U et al (2015) Ewing sarcoma: current management and future approaches through collaboration. J Clin Oncol 33:3036–3046PubMedCrossRef
27.
Zurück zum Zitat Gerrand C, Bate J, Seddon B et al (2020) Seeking international consensus on approaches to primary tumour treatment in Ewing sarcoma. Clin Sarcoma Res 10:21PubMedPubMedCentralCrossRef Gerrand C, Bate J, Seddon B et al (2020) Seeking international consensus on approaches to primary tumour treatment in Ewing sarcoma. Clin Sarcoma Res 10:21PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Granowetter L, Womer R, Devidas M et al (2009) Dose-intensified compared with standard chemotherapy for nonmetastatic Ewing sarcoma family of tumors: a children’s oncology group study. J Clin Oncol 27:2536–2541PubMedPubMedCentralCrossRef Granowetter L, Womer R, Devidas M et al (2009) Dose-intensified compared with standard chemotherapy for nonmetastatic Ewing sarcoma family of tumors: a children’s oncology group study. J Clin Oncol 27:2536–2541PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Grier HE, Krailo MD, Tarbell NJ et al (2003) Addition of ifosfamide and etoposide to standard chemotherapy for Ewing’s sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med 348:694–701PubMedCrossRef Grier HE, Krailo MD, Tarbell NJ et al (2003) Addition of ifosfamide and etoposide to standard chemotherapy for Ewing’s sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med 348:694–701PubMedCrossRef
30.
Zurück zum Zitat Grünewald TGP, Cidre-Aranaz F, Surdez D et al (2018) Ewing sarcoma. Nat Rev Dis Primers 4:5PubMedCrossRef Grünewald TGP, Cidre-Aranaz F, Surdez D et al (2018) Ewing sarcoma. Nat Rev Dis Primers 4:5PubMedCrossRef
31.
Zurück zum Zitat Guenther LM, Dharia NV, Ross L et al (2019) A combination CDK4/6 and IGF1R inhibitor strategy for Ewing sarcoma. Clin Cancer Res 25:1343–1357PubMedCrossRef Guenther LM, Dharia NV, Ross L et al (2019) A combination CDK4/6 and IGF1R inhibitor strategy for Ewing sarcoma. Clin Cancer Res 25:1343–1357PubMedCrossRef
32.
Zurück zum Zitat Haeusler J, Ranft A, Boelling T et al (2010) The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES). Cancer 116:443–450PubMedCrossRef Haeusler J, Ranft A, Boelling T et al (2010) The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES). Cancer 116:443–450PubMedCrossRef
34.
Zurück zum Zitat Hesla AC, Tsagozis P, Jebsen N et al (2016) mproved prognosis for patients with Ewing sarcoma in the sacrum compared with the innominate bones: the Scandinavian sarcoma group experience. J Bone Joint Surg Am 98:199–210PubMedCrossRef Hesla AC, Tsagozis P, Jebsen N et al (2016) mproved prognosis for patients with Ewing sarcoma in the sacrum compared with the innominate bones: the Scandinavian sarcoma group experience. J Bone Joint Surg Am 98:199–210PubMedCrossRef
35.
Zurück zum Zitat Italiano A, Mir O, Mathoulin-Pelissier S et al (2020) Cabozantinib in patients with advanced Ewing sarcoma or osteosarcoma (CABONE): a multicentre, single-arm, phase 2 trial. Lancet Oncol 21:446–455PubMedPubMedCentralCrossRef Italiano A, Mir O, Mathoulin-Pelissier S et al (2020) Cabozantinib in patients with advanced Ewing sarcoma or osteosarcoma (CABONE): a multicentre, single-arm, phase 2 trial. Lancet Oncol 21:446–455PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Keole S, Ashman JB, Daniels TB (2014) Proton therapy for sarcomas. Cancer J 20:409–414PubMedCrossRef Keole S, Ashman JB, Daniels TB (2014) Proton therapy for sarcomas. Cancer J 20:409–414PubMedCrossRef
37.
Zurück zum Zitat Ladenstein R, Potschger U, Le Deley MC et al (2010) Primary disseminated multifocal Ewing sarcoma: results of the Euro-EWING 99 trial. J Clin Oncol 28:3284–3291PubMedCrossRef Ladenstein R, Potschger U, Le Deley MC et al (2010) Primary disseminated multifocal Ewing sarcoma: results of the Euro-EWING 99 trial. J Clin Oncol 28:3284–3291PubMedCrossRef
38.
Zurück zum Zitat Laskar S, Sinha S, Chatterjee A, Khanna NR, Puri A, Gulia A, Nayak P, Vora T, Chinnaswamy G, Prasad M, Juvekar S, Desai S, Janu A, Rangarajan V, Purandare N, Shah S, Rekhi B, Jambhekar N, Muckaden MA, Kurkure P (2019) Radiotherapy dose escalation in unresectable ewing’s sarcoma/PNET: final results of a phase III randomized controlled trial. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2019.06.504CrossRef Laskar S, Sinha S, Chatterjee A, Khanna NR, Puri A, Gulia A, Nayak P, Vora T, Chinnaswamy G, Prasad M, Juvekar S, Desai S, Janu A, Rangarajan V, Purandare N, Shah S, Rekhi B, Jambhekar N, Muckaden MA, Kurkure P (2019) Radiotherapy dose escalation in unresectable ewing’s sarcoma/PNET: final results of a phase III randomized controlled trial. Int J Radiat Oncol Biol Phys. https://​doi.​org/​10.​1016/​j.​ijrobp.​2019.​06.​504CrossRef
39.
Zurück zum Zitat Le Deley MC, Paulussen M, Lewis I et al (2014) Cyclophosphamide compared with ifosfamide in consolidation treatment of standard-risk Ewing sarcoma: results of the randomized noninferiority Euro-EWING99-R1 trial. J Clin Oncol 32:2440–2448PubMedCrossRef Le Deley MC, Paulussen M, Lewis I et al (2014) Cyclophosphamide compared with ifosfamide in consolidation treatment of standard-risk Ewing sarcoma: results of the randomized noninferiority Euro-EWING99-R1 trial. J Clin Oncol 32:2440–2448PubMedCrossRef
40.
Zurück zum Zitat Leavey PJ, Laack NN, Krailo MD et al (2021) Phase III trial adding vincristine-topotecan-cyclophosphamide to the initial treatment of patients with nonmetastatic ewing sarcoma: a children’s oncology group report. J Clin Oncol 39:4029–4038PubMedCrossRef Leavey PJ, Laack NN, Krailo MD et al (2021) Phase III trial adding vincristine-topotecan-cyclophosphamide to the initial treatment of patients with nonmetastatic ewing sarcoma: a children’s oncology group report. J Clin Oncol 39:4029–4038PubMedCrossRef
41.
42.
Zurück zum Zitat Luksch R, Tienghi A, Hall KS et al (2012) Primary metastatic Ewing’s family tumors: results of the Italian sarcoma group and Scandinavian sarcoma group ISG/SSG IV study including myeloablative chemotherapy and total-lung irradiation. Ann Oncol 23:2970–2976PubMedCrossRef Luksch R, Tienghi A, Hall KS et al (2012) Primary metastatic Ewing’s family tumors: results of the Italian sarcoma group and Scandinavian sarcoma group ISG/SSG IV study including myeloablative chemotherapy and total-lung irradiation. Ann Oncol 23:2970–2976PubMedCrossRef
43.
Zurück zum Zitat Mounessi FS, Lehrich P, Haverkamp U et al (2013) Pelvic Ewing sarcomas. Three-dimensional conformal vs. intensity-modulated radiotherapy. Strahlenther Onkol 189:308–314PubMedCrossRef Mounessi FS, Lehrich P, Haverkamp U et al (2013) Pelvic Ewing sarcomas. Three-dimensional conformal vs. intensity-modulated radiotherapy. Strahlenther Onkol 189:308–314PubMedCrossRef
44.
Zurück zum Zitat Pappo AS, Dirksen U (2018) Rhabdomyosarcoma, Ewing sarcoma, and other round cell sarcomas. J Clin Oncol 36:168–179PubMedCrossRef Pappo AS, Dirksen U (2018) Rhabdomyosarcoma, Ewing sarcoma, and other round cell sarcomas. J Clin Oncol 36:168–179PubMedCrossRef
45.
Zurück zum Zitat Paulino AC, Nguyen TX, Mai WY et al (2007) Dose response and local control using radiotherapy in non-metastatic Ewing sarcoma. Pediatr Blood Cancer 49:145–148PubMedCrossRef Paulino AC, Nguyen TX, Mai WY et al (2007) Dose response and local control using radiotherapy in non-metastatic Ewing sarcoma. Pediatr Blood Cancer 49:145–148PubMedCrossRef
46.
Zurück zum Zitat Paulussen M, Craft AW, Lewis I et al (2008) Results of the EICESS-92 study: two randomized trials of Ewing’s sarcoma treatment—cyclophosphamide compared with ifosfamide in standard-risk patients and assessment of benefit of etoposide added to standard treatment in high-risk patients. J Clin Oncol 26:4385–4393PubMedCrossRef Paulussen M, Craft AW, Lewis I et al (2008) Results of the EICESS-92 study: two randomized trials of Ewing’s sarcoma treatment—cyclophosphamide compared with ifosfamide in standard-risk patients and assessment of benefit of etoposide added to standard treatment in high-risk patients. J Clin Oncol 26:4385–4393PubMedCrossRef
47.
Zurück zum Zitat Rao A, Chen Q, Ermoian R et al (2017) Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium: Rao et al. Pediatr Blood Cancer 64:e26589CrossRef Rao A, Chen Q, Ermoian R et al (2017) Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium: Rao et al. Pediatr Blood Cancer 64:e26589CrossRef
48.
Zurück zum Zitat Sankar S, Theisen ER, Bearss J et al (2014) Reversible LSD1 inhibition interferes with global EWS/ETS transcriptional activity and impedes Ewing sarcoma tumor growth. Clin Cancer Res 20:4584–4597PubMedPubMedCentralCrossRef Sankar S, Theisen ER, Bearss J et al (2014) Reversible LSD1 inhibition interferes with global EWS/ETS transcriptional activity and impedes Ewing sarcoma tumor growth. Clin Cancer Res 20:4584–4597PubMedPubMedCentralCrossRef
49.
Zurück zum Zitat Schuck A, Ahrens S, Paulussen M et al (2003) Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. Int J Radiat Oncol Biol Phys 55:168–177PubMedCrossRef Schuck A, Ahrens S, Paulussen M et al (2003) Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. Int J Radiat Oncol Biol Phys 55:168–177PubMedCrossRef
50.
Zurück zum Zitat Scobioala S, Ranft A, Wolters H et al (2018) Impact of whole lung irradiation on survival outcome in patients with lung relapsed Ewing sarcoma. Int J Radiat Oncol Biol Phys 102:584–592PubMedCrossRef Scobioala S, Ranft A, Wolters H et al (2018) Impact of whole lung irradiation on survival outcome in patients with lung relapsed Ewing sarcoma. Int J Radiat Oncol Biol Phys 102:584–592PubMedCrossRef
51.
Zurück zum Zitat Seddon BM, Cassoni AM, Galloway MJ et al (2005) Fatal radiation myelopathy after high-dose busulfan and melphalan chemotherapy and radiotherapy for Ewing’s sarcoma: a review of the literature and implications for practice. Clin Oncol 17:385–390CrossRef Seddon BM, Cassoni AM, Galloway MJ et al (2005) Fatal radiation myelopathy after high-dose busulfan and melphalan chemotherapy and radiotherapy for Ewing’s sarcoma: a review of the literature and implications for practice. Clin Oncol 17:385–390CrossRef
52.
Zurück zum Zitat Strauss SJ, Frezza AM, Abecassis N et al (2021) Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol 32:1520–1536PubMedCrossRef Strauss SJ, Frezza AM, Abecassis N et al (2021) Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol 32:1520–1536PubMedCrossRef
53.
Zurück zum Zitat Su Z, Indelicato DJ, Mailhot RB et al (2020) Impact of different treatment techniques for pediatric Ewing sarcoma of the chest wall: IMRT, 3DCPT, and IMPT with/without beam aperture. J Appl Clin Med Phys 21:100–107PubMedPubMedCentralCrossRef Su Z, Indelicato DJ, Mailhot RB et al (2020) Impact of different treatment techniques for pediatric Ewing sarcoma of the chest wall: IMRT, 3DCPT, and IMPT with/without beam aperture. J Appl Clin Med Phys 21:100–107PubMedPubMedCentralCrossRef
54.
Zurück zum Zitat Talleur AC, Navid F, Spunt SL et al (2016) Limited margin radiation therapy for children and young adults with Ewing sarcoma achieves high rates of local tumor control. Int J Radiat Oncol Biol Phys 96:119–126PubMedPubMedCentralCrossRef Talleur AC, Navid F, Spunt SL et al (2016) Limited margin radiation therapy for children and young adults with Ewing sarcoma achieves high rates of local tumor control. Int J Radiat Oncol Biol Phys 96:119–126PubMedPubMedCentralCrossRef
55.
Zurück zum Zitat Toretsky JA, Gorlick R (2010) IGF-1R targeted treatment of sarcoma. Lancet Oncol 11:105–106PubMedCrossRef Toretsky JA, Gorlick R (2010) IGF-1R targeted treatment of sarcoma. Lancet Oncol 11:105–106PubMedCrossRef
56.
Zurück zum Zitat Wexler LH, Delaney TF, Tsokos M et al (1996) Ifosfamide and etoposide plus vincristine, doxorubicin, and cyclophosphamide for newly diagnosed Ewing’s sarcoma family of tumors. Cancer 78:901–911PubMedCrossRef Wexler LH, Delaney TF, Tsokos M et al (1996) Ifosfamide and etoposide plus vincristine, doxorubicin, and cyclophosphamide for newly diagnosed Ewing’s sarcoma family of tumors. Cancer 78:901–911PubMedCrossRef
57.
Zurück zum Zitat Whelan J, Le Deley MC, Dirksen U et al (2018) High-dose chemotherapy and blood autologous stem-cell rescue compared with standard chemotherapy in localized high-risk ewing sarcoma: results of Euro‑E.W.I.N.G.99 and Ewing-2008. J Clin Oncol 36:Jco2018782516CrossRef Whelan J, Le Deley MC, Dirksen U et al (2018) High-dose chemotherapy and blood autologous stem-cell rescue compared with standard chemotherapy in localized high-risk ewing sarcoma: results of Euro‑E.W.I.N.G.99 and Ewing-2008. J Clin Oncol 36:Jco2018782516CrossRef
58.
Zurück zum Zitat Womer RB, West DC, Krailo MD et al (2012) Randomized controlled trial of interval-compressed chemotherapy for the treatment of localized Ewing sarcoma: a report from the children’s oncology group. J Clin Oncol 30:4148–4154PubMedPubMedCentralCrossRef Womer RB, West DC, Krailo MD et al (2012) Randomized controlled trial of interval-compressed chemotherapy for the treatment of localized Ewing sarcoma: a report from the children’s oncology group. J Clin Oncol 30:4148–4154PubMedPubMedCentralCrossRef
59.
Zurück zum Zitat Zöllner SK, Amatruda JF, Bauer S et al (2021) Ewing sarcoma-diagnosis, treatment, clinical challenges and future perspectives. J Clin Med 10(8):1685PubMedPubMedCentralCrossRef Zöllner SK, Amatruda JF, Bauer S et al (2021) Ewing sarcoma-diagnosis, treatment, clinical challenges and future perspectives. J Clin Med 10(8):1685PubMedPubMedCentralCrossRef
Metadaten
Titel
Aktuelle Überlegungen zur System- und Lokaltherapie beim Ewing-Sarkom
verfasst von
Prof. Dr. med. Beate Timmermann
D. Andreou
U. Dirksen
Publikationsdatum
22.03.2022
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 7/2022
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-022-01128-5

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