TY - JOUR
T1 - The GPO Cooperative Ewing's Sarcoma Studies CESS 81/86: Report after 6 1/2 years
AU - Jurgens, H.
AU - Bier, V.
AU - Dunst, J.
AU - Harms, D.
AU - Jobke, A.
AU - Kotz, R.
AU - Kuhl, J.
AU - Muller-Weihrich, St
AU - Ritter, J.
AU - Salzer-Kuntschik, M.
AU - Sauer, R.
AU - Sternschulte, W.
AU - Treuner, J.
AU - Voute, P. A.
AU - Weinel, P.
AU - Winkelmann, W.
AU - Winkler, K.
AU - Gobel, U.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1988
Y1 - 1988
N2 - The GPO Cooperative Ewing's Sarcoma Study (CESS) 81 with 10 months four-drug combination chemotherapy (vincristine, actinomycin D, cyclophosphamide, and adriamycin = VACA) and local control with surgery and/or radiation, following week 18, resulted in a Kaplan-Meier estimated disease-free survival of 51% after 6 1/2 years (51/93 patients disease-free). Tumor volume and histological response to primary chemotherapy were identified as most significant prognostic factors. As a consequence, the CESS 86 regimen was stratified according to risk of relapse. Standard risk patients (extremity tumors < 100 ml tumor volume) were continued on VACA chemotherapy. In high risk patients (extremity tumors > 100 ml tumor volume, central tumors), cyclophosphamide in conventional dose (1200 mg/m2/course) was replaced by high doses of ifosfamide (6 g/m2/course) with mesna uroprotection (VAIA). Local control was obtained following week 9. Patients with radiation were randomised for conventional fractionation or accelerated split-course hyperfractionation. The study was piloted from February to December 1985. 27/37 patients were disease-free on October 1, 1987. The ongoing trial was started on January 1, 1986. On October 1, 1987, 63/66 patients were disease-free. In patients with large primaries, according to Kaplan-Meier life-table analysis, the disease-free survival was significantly better in patients receiving VAIA chemotherapy, compared to the previous VACA regimen. The toxicity of both combination chemotherapy regimens was comparable.
AB - The GPO Cooperative Ewing's Sarcoma Study (CESS) 81 with 10 months four-drug combination chemotherapy (vincristine, actinomycin D, cyclophosphamide, and adriamycin = VACA) and local control with surgery and/or radiation, following week 18, resulted in a Kaplan-Meier estimated disease-free survival of 51% after 6 1/2 years (51/93 patients disease-free). Tumor volume and histological response to primary chemotherapy were identified as most significant prognostic factors. As a consequence, the CESS 86 regimen was stratified according to risk of relapse. Standard risk patients (extremity tumors < 100 ml tumor volume) were continued on VACA chemotherapy. In high risk patients (extremity tumors > 100 ml tumor volume, central tumors), cyclophosphamide in conventional dose (1200 mg/m2/course) was replaced by high doses of ifosfamide (6 g/m2/course) with mesna uroprotection (VAIA). Local control was obtained following week 9. Patients with radiation were randomised for conventional fractionation or accelerated split-course hyperfractionation. The study was piloted from February to December 1985. 27/37 patients were disease-free on October 1, 1987. The ongoing trial was started on January 1, 1986. On October 1, 1987, 63/66 patients were disease-free. In patients with large primaries, according to Kaplan-Meier life-table analysis, the disease-free survival was significantly better in patients receiving VAIA chemotherapy, compared to the previous VACA regimen. The toxicity of both combination chemotherapy regimens was comparable.
UR - http://www.scopus.com/inward/record.url?scp=0024010940&partnerID=8YFLogxK
U2 - 10.1055/s-2008-1033716
DO - 10.1055/s-2008-1033716
M3 - Journal articles
C2 - 3145357
AN - SCOPUS:0024010940
SN - 0300-8630
VL - 200
SP - 243
EP - 252
JO - Klinische Padiatrie
JF - Klinische Padiatrie
IS - 3
ER -