Informatie over actuele ontwikkelingen in zowel reguliere als alternatieve en/of aanvullende behandelingen en middelen bij Sarcomen - weke delen kanker en Ewingsarcoma.
Ewing-sarcoom (ES) is de tweede meest voorkomende vorm van primaire botkanker bij kinderen en jonge volwassenen. De overlevingskansen voor lokale vormen van het Ewing sarcoom zijn verbeterd naar percentages van boven de 70% voornamelijk door agressieve chemobehandleingen en lokale bestraling. Aan de andere kant, is er weinig verbetering in de overlevingskansen van patiënten met een recideif van het Ewing sarcoom of met bij de diagnose al uitzaaiingen. Tohc is er wel hoop vooral met stamceltransplantaies en immuuntherapie al of niet aangevuld met hyperthermie.
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Chemo bij Ewingsarcoma
Oktober 2004: Bron: Pubmed In Pubmed is een studie gepubliceerd die twee verschillende chemokuren als behandeling van het Ewingsarcoom met elkaar vergelijkt. Hier het abstract van deze studie:
Am J Clin Oncol. 2004 Oct;27(5):529-34. VIP (Etoposide, Ifosfamide, Cisplatin) in Adult Patients With Recurrent or Refractory Ewing Sarcoma Family of Tumors. El Weshi A, Memon M, Raja M, Bazarbashi S, Rahal M, El Foudeh M, Pai C, Allam A, El Hassan I, Ezzat A. From the From Department of Medical Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Despite the fact that Ewing sarcoma family of tumors (ET) is chemosensitive, long-term survival is extremely rare for patients with primary refractory or recurrent disease. There is no standard salvage chemotherapy regimen available in this context. In this study the authors reviewed their experience with the combination of etoposide, ifosfamide, and cisplatin in adult patients with recurrent or refractory disease.
From February 1997 through December 2001, they evaluated the efficacy of etoposide (75 mg/m/day for 5 days), ifosfamide (1,200 mg/m/day for 5 days), and cisplatin (20 mg/m/day for 5 days) combination chemotherapy (VIP regimen), as second-line salvage therapy in 27 patients with recurrent or refractory ET. All patients were evaluated for response, time to progression, and overall survival. Twenty-one male and 6 female patients with recurrent (n = 14) and refractory (n = 13) disease were treated with the VIP regimen. Median age was 18 years (range, 16-34 years). Twenty-two patients were previously treated with vincristine, Adriamycin, ifosfamide, and actinomycin-D; and 5 patients were treated with cyclophosphamide, Adriamycin, and vincristine. Sites of recurrent or progressive disease included local (n = 3), distant (n = 11), and both local and distant (n = 13). A total of 129 cycles of VIP were given (median, 5 cycles/patient; range, 1-14 cycles/patient). One patient (4%) had a complete response (CR) and 8 patients (30%) had a partial response (PR), for an overall response rate of 34%. The median number of cycles given to patients with CR + PR was 6 (range, 3-14 cycles).
Nine patients (33%) had stable disease and 9 (33%) had disease progression. Median time to progression and median overall survival were 6.6 months and 8.1 months respectively for all patients, and 12.8 months and 14.2 months respectively for responders. There were no toxic deaths. Major toxicities included grade IV granulocytopenia in 19 patients and grades III/IV thrombocytopenia in 15 patients. At a median follow-up of 8 months (range, 2-56 months), 24 patients died of disease progression, 2 patients are alive with disease, and 1 patient is alive with no evidence of disease.
The authors conclude that the VIP combination is active in patients with recurrent/refractory ET, with acceptable toxicity, and offers good palliation. Cisplatin-based combination chemotherapy merits further investigation, possibly as first-line treatment in this disease. PMID: 15596925 [PubMed - in process]
