Ewing Sarcoma: A 15-Year Experience of a Single Center With the MSKCC P6 Treatment Protocol

J Pediatr Hematol Oncol. 2016 Jan;38(1):38-42. doi: 10.1097/MPH.0000000000000456.

Abstract

Introduction: Ewing sarcoma (ES) is the second most common bone tumor in children. Current chemotherapeutic regimens include high-dose anthracyclines and alkylating agents with significant variation in treatment length. The Memorial Sloan Kettering Cancer Center P6 regimen (MSKCC P6) treatment protocol is a highly aggressive regimen given over 21 weeks only. We present the outcome of ES patients treated in our center with this protocol over the last 15 years.

Procedure: We retrospectively analyzed data on the presentation, patient characteristics, treatment, and outcome of all ES patients treated according to the MSKCC P6 regimen from 1999 to 2014.

Results: Of 48 patients, 37 (77%) presented with a nonmetastatic disease and 26 (54%) with tumor located in the extremities. The 5-year overall survival (OS) of the entire cohort was 55.9% ± 8%. Nonmetastatic disease conferred a better prognosis with a 5-year OS of 68.4% ± 8.5%. Patients with a nonmetastatic extremity tumor had the most favorable outcome with 5-year OS of 72.2% ± 9.8%.

Conclusion: The outcome of ES patients after a short aggressive course of chemotherapy (the MSKCC P6 protocol), is comparable to that following other first-line treatment regimens in use, with potentially fewer long-term adverse events.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / mortality
  • Child
  • Child, Preschool
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Ifosfamide / therapeutic use
  • Kaplan-Meier Estimate
  • Male
  • Prognosis
  • Retrospective Studies
  • Sarcoma, Ewing / drug therapy*
  • Sarcoma, Ewing / mortality
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Ifosfamide

Supplementary concepts

  • IVAD protocol