Standard risk, localized |
Standard risk, localized |
Standard risk,
localized |
Standard risk, localized |
Standard risk, localized |
Standard risk, localized |
Paulussen49
|
EICESS-92
|
Localized, Tumor volume <100ml
|
155
|
Induction (VAIA x4) +
Randomization: VAIA x10 vs. VACA x10 (cyclophosphamide vs
ifosfamide)
|
3y EFS 74% vs. 73%,
HRs for EFS and overall survival 0.91 VAIA vs. VACA
|
Le Deley50
|
Euro-Ewing99 R1
|
<50yo
Localized, either good histologic response (>90%) or Tumor
volume (<200ml)
|
856
|
Induction (VIDE x6, VAI x1)
Randomization:
VAIx7 vs. VACx7
|
3y EFS and overall survival for
VAI vs. VAC,
78.2% vs. 75.4% and 85.5% vs. 85.9%
|
Localized |
Localized |
Localized |
Localized |
Localized |
Localized |
Grier48
|
INT-0091 (CCG-7881 and POG-8850)
|
<30yo
|
398
|
Standard (VACA) vs experimental (VACA + IE)
|
5yr EFS and overall survival for standard vs. experimental,
54% vs. 69% (p 0.005) and 61% vs. 72% (p 0.01)
|
Granowetter163
|
INT-0154
|
<30yo
Localized, bone + soft tissue
|
478
|
VDC/IE (17 cycles, 48 weeks) vs. dose intensified VDC/IE (11 cycles, 30
weeks)
|
5y EFS and overall survival for standard vs. dose intensified,
72.1% vs. 70.1% and 80.5% vs. 77%
|
Womer52
|
COG AEWS0031
|
<50yr age
Localized
|
568
|
Randomization: VDC/IE standard (q3/52) vs. VDC/IE intensified
(q2/52)
|
3y EFS and overall survival for std vs. intensified, 65% vs. 73%
(p 0.048) and 77% vs. 83% (p 0.056)
Similar toxicity
|
High risk, localized* |
High risk, localized* |
High risk, localized* |
High risk, localized* |
High risk, localized* |
High risk,
localized* |
Whelan105
|
Euro-Ewing99/ Ewing-2008
|
<50yo
Poor histologic response (≤90%), Tumor volume ≥200ml
|
240
|
Induction (VIDEx6, VAIx1)
Randomization:
VAI vs. Bu-Mel/ ASCT
|
8y EFS and overall survival for VAI vs. Bu-Mel, 47.1% vs. 60.7%
(P 0.026) and 55.6% vs. 64.5% (p 0.028)
|
Metastatic (lungs only) |
Metastatic (lungs only) |
Metastatic (lungs
only) |
Metastatic (lungs only) |
Metastatic (lungs only) |
Metastatic
(lungs only) |
Dirksen106
|
Euro-Ewing99 R2Pulm/ EWING-2008
|
<50yo
Pulmonary/pleural metastases, nil other
|
287
|
VAI + WLI
vs.
Bu-Mel
|
3y EFS 50.6% vs. 56.6%, HR= 0.79, p=0.16
3yr OS 68% vs. 68.2%, HR=1.00, p=0.99
|
Multisite-metastatic (other) |
Multisite-metastatic (other) |
Multisite-metastatic (other) |
Multisite-metastatic (other) |
Multisite-metastatic (other) |
Multisite-metastatic
(other) |
Paulussen49
|
EICESS-92
|
Volume ≥100ml or ±Metastases (any)
|
492
|
VAIA x14 vs.
EVAIA x4 + EVAIAx10
(addition of etoposide)
|
3y EFS 47% vs. 52% (p=0.47)
|
Brennan54
|
Euro-Ewing-2012
|
<50yo
Localized +/- Metastases (lung or other)
|
640
|
VIDE/ VAI vs. VDC/ IE
|
HRs 0.70 for EFS, 0.64 for overall survival in favor of VDC/ IE
|