Hyperfractionated radiotherapy with simultaneous chemotherapy in Ewing's sarcoma

Simultaneous application of radiotherapy and chemotherapy is going on to be studied in several tumors. Preliminary data are encouraging, e.g. in bladder cancer, head and neck cancer, anal cancer. Ewing's sarcoma is a fast growing tumor responding to both drug and radiation therapy. Theoretically, simultaneous application of both treatment modalities could be superior to sequential therapy. Therefore, a new fractionation scheme with simultaneous chemotherapy has been introduced in the protocol for Ewing's sarcoma (CVESS 86). The preliminary data document that there is no enhancement of acute treatment toxicity. This is in so far encouraging as even actinomycin D and adriamycine are included in the chemotherapy. The new treatment scheme can be considered as feasible and safe from our data. Nevertheless, conclusions concerning therapeutic gain or late effects cannot be drawn at this moment.