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- Titel:
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.
- Dokumenttyp:
- Journal Article; Research Support, Non-U.S. Gov't; Article
- Autor(en):
- Burdach, S; Thiel, U; Schöniger, M; Haase, R; Wawer, A; Nathrath, M; Kabisch, H; Urban, C; Laws, HJ; Dirksen, U; Steinborn, M; Dunst, J; Jürgens, H
- Abstract:
- 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.
- Zeitschriftentitel:
- Bone Marrow Transplant
- Jahr:
- 2010
- Band / Volume:
- 45
- Heft / Issue:
- 3
- Seitenangaben Beitrag:
- 483-9
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1038/bmt.2009.184
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/19684633
- Print-ISSN:
- 0268-3369
- TUM Einrichtung:
- Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin
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