Evidence brief
Ewing Sarcoma: Multimodality Treatment
Chemotherapy + local control (surgery and/or radiation)
VDC/IE or VIDE protocols standard
Surgery preferred for local control when possible
Radiation for unresectable or poor surgical margins
5-year survival 60-70% localized disease
Ewing sarcoma requires intensive multimodality treatment. Unlike osteosarcoma, radiation is effective and may be used for local control.
Key differences from osteosarcoma: smaller round blue cells, radiation sensitive, may present with systemic symptoms. Treatment: neoadjuvant chemo → surgery or radiation → adjuvant chemo. Surgery preferred if achievable with good function. Metastatic disease has poor prognosis.
Juergens C et al. Safety assessment of intensive induction with vincristine, ifosfamide, doxorubicin, and etoposide (VIDE) in the treatment of Ewing tumors in the EURO-EWING 99 clinical trial. Pediatr Blood Cancer. 2006;47(1):22-29.
Level II
Lesser quality RCT or prospective comparative study