Table 2. Studies Using HDCT and ASCT in Relapsed Ewing's Sarcoma.
A: dactinomycin; ASCT: autologous stem cell transplant; C: cyclophosphamide; Ca: Carboplatin; CR: complete response; D: doxorubicin; E: etoposide; EFS: event-free survival; HDCT: high-dose chemotherapy; I: ifosmade; Ir: irinotecan; M: methotrexate; NL: Not listed; No: number; OS: overall survival; PR: partial response; SCT: stem cell transplant; T: topotecan; TBI: total body irradiation; Te: temozolomide; V: vincristine; Ω: topotecan, Cytoxan, irinotecan; C1: High-dose chemotherapy regimen 1; C2: High-dose chemotherapy regimen 2; PSBC: Peripheral blood stem cells: BSC: Bone marrow stem cells.
| Study | Median age (yr.) | No. of pts | Type of relapse (No. of pts) | Chemotherapy | HDCT (mg/m2; mg/kg) | Source of stem cell | Response (No. of pts) | EFS | OS |
| Rasper et al. 2014 [18] | NL | 239 | Local (42), Distant (142), Combined (30) | T/C, I/Te, If/E/Carboplatin | C1: Busulfan/Melphalan (NL); C2: Treosulfan/Melphalan (NL); Others: Ω | NL | C1: CR (5) PR (2) C2: CR (19) PR (8) | 2 yr HDCT – 44% w/o HDCT-10% (p value: 0.01); 5 yr. HDCT – 24% w/o HDCT - 6% (p value: 0.01) | 2 yr HDCT-66% w/o HDCT-22%; 5 yr HDCT - 42% w/o HDCT - 10% (p value: 0.01) |
| Barker et al. 2005 [15] | 13.5 | 55 | Local (6); Distant (39); Combined (10) | VDC - IE; VACIME; VDC-A; VDC-A-M | Busulfan/melphalan/ thiotepa (NL) | PBSC | CR/PR (27) | 5 yr HDCT: 61% w/o HDCT: 7% | 5 yr HDCT: 77% w/o HDCT: 7% |
| Ferrari et al. 2015 [16] | NL | 107 | Local (11); Distant (96) | VDCAIE | Busulfan/melphalan (4 mg/kg and 140 mg/m2) | PBSC | NL | NL | HDCT: 5 yr OS 50% |
| Palmerini et al. 2009 abstract | 17 | 72 | Local (11) | NL | Busulfan/melphalan (4 mg/kg and 140 mg/m2) Palliative | NL | NL | NL | HDCT: 3 yr OS 21% |
| McTiernan et al. 2006 [14] | 19 | 33 | Local (11) Distant (18); Combined (4) | Ca, E C A I D V | Busulfan/melphalan (600 mg/m2/140 mg/m2) - 22 pts Melphalan/etoposide (130 mg/m2/60 mg/m2) - 7 pts TBI Melphalan/Cytoxan (16 mg/kg/60 mg/kg) - 1 pt. Melphalan (150 mg/m2) – 3 pts | PBSC BSC | Prior to HDCT: CR (14) PR (10) Post-HDCT: CR (21) PR (2) | 2 yr EFS 42.5%; 5 yr EFS 38.5% | 2 yr OS 50.7%; 5 yr OS 42.8% |
| Shankar et al. 2003 [17] | 14 | 64 | Local (11) | Ca/E, C/E /Ca, C/E | Melphalan (NL) TBI | PBSC BSC | NL | 3.5 yr EFS 14% | 3.5 yr OS 28% |
| Bacci et al. 2003 [3] | 18 | 138 | Distant (138) | none | Melphalan (NL) Busulfan (NL) | PSBC BSC | NL | NL | 5 yr only HDCT – 0% w/o HDCT – 0% |