Role of High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for Children and Young Adults with Relapsed Ewing’s Sarcoma: A Systematic Review

Table 3

Studies consisting of patients with mixture of relapsed and primary metastatic Ewing’s sarcoma (combined outcomes for all patients reported).

Study	Average age (years)	Total number of pts	ES (number of pts)	Number of HDCT patients (ES rel)	Chemotherapy	Response (number of pts)	HDCT (mg/m^2; mg/kg)	Source of stem cell	EFS	OS
Al-Faris et al. 2007, retrospective [29]	12.5	45	Total (45); Relapsed (19)	6	TC; ICE; V; D	RP.SA	Etoposide (2400 mg/m^2); Cytoxan (60 mg/kg/dose); Melphalan (180 mg/m^2/dose)	PBSC	All pts: HDCT: 1.5 yr EFS 60%/3 yr EFS 39%; Without HDCT: 1.5 yr EFS 36%/3 yr EFS 32%	All pts: HDCT: 1.5 yr OS 70%/3 yr OS 59%; Without HDCT: 1.5 yr OS 44%/3 yr OS 34%
Fraser et al. 2006, prospective single arm [30]	11.5	36	Total (16); Relapse (6)	5	ICE; V; C	CR (3); PR (3)	Melphalan (50 mg/m^2); Busulfan (4 mg/kg); Thiotepa (250/m^2)	PBSC; BSC	NL	ES family-1 yr OS 69%/3 yr. OS 54% (HDCT)
Pape et al. 1999, retrospective [31]	NL	39	39; No information on rel pts	NL	EVAIA	NL	Melphalan (30 mg/m^2); Etoposide (1800 mg/m^2)	PBSC	NL	All pts: 3.5 yr OS 31% (HDCT)
Kavan et al. 1999, prospective single Arm [32]	12.6	31	Total (27)	NL	NL	NL	Melphalan (NL); Etoposide (NL); Carboplatin (NL); TBI	NL	NL	All pts: 1.5 yr OS 58% (HDCT)
Ladenstein et al. 1995, registry [33]	13	63	Total (50); Relapsed (24); Relapsed EFT (31)	24	VAC/VAD; IVA/IVAD	CR (24)	G1: M + V or E + C (NL); G2: M + B ± Cy(NL); G3: (NL); M + Ba + V; M + Ba + P; M + Ba + T; G4 (NL); Th + V + I + Ci; G5 (NL); M + V + TBI; M + C + TBI; M + Ci + TBI	PBSC; BSC	All pts: 5 yr-27%; Relapsed pts (EFT) ()-5 yr EFS 32%; Primary MET pts-5 yr EFS-21% (HDCT)	NL

TC: topotecan and cyclophosphamide, ICE: ifosfamide, carboplatin, and etoposide, EVAIA: etoposide, vincristine, adriamycin, ifosfamide, and actinomycin D, HDCT: high-dose chemotherapy, TBI: total body irradiation, CR: complete response, PR: partial response, PBSC: peripheral blood stem cell, BSC: bone marrow stem cell, EFS: event-free survival, OS: overall survival, NL: not listed, V: vincristine, E: etoposide, C: carboplatin, T: teneposide, I: ifosphamide, A: adriamycin, D: doxorubicin, M: melphalan, V: vincristine, B: busulfan, Cy: cyclophosphamide, Ba: bichloronitrosourea, P: procarbazine, Ci: cisplatin, A: adriamycin, ES: Ewing’s sarcoma, rel: relapsed, RP.SA: response present, specifics unavailable, RFS: relapse-free survival, and ES rel: patients with relapsed ES that got HDCT.