Serhan KÜPELİ, Hakan GELİNCİK

LongtermsurvivalinapatientwithrecurrentmetastaticEwingsarcoma treated with irinotecan and temozolomide

Ewing sarkoma tümör ailesi, osteosarkomdan sonra çocuklar ve genç erişkinlerde en sık görülen kemik tümörüdür. Relaps/rekürren Ewing sarkoma tedavisinde çeşitli kemoterapi rejimleri kullanılır. İrinotekan ve temozolomid kombinasyonu ile ümit verici sonuçlar elde edilmiştir. 13 yaşında kadın relaps Ewing sarkomu olan hastamızın, 12 siklus irinotekan (20 mg/m2/10 gün) ve temozolomid (100mg/m2/5 gün) tedavisi sonrası bir şikayeti olmadı ve radyolojik lezyonları 66 ay boyunca stabil kaldı. İrinotekan ve temozolomid relaps/rekürren Ewing sarkoma tedavisinde başarıyla kullanılmıştır, fakat bu tedavi protokolünün etkinliğinin kanıtlanması için daha geniş hasta gruplarıyla randomize prospektif çalışmalara ihtiyaç vardır

İrinotekan ve temozolomid ile tedavi edilen rekürren metastatik Ewing sarkoma hastasında uzun süreli sağkalım

Ewing sarcoma family of tumor is the second most common bone tumor in children and young adults, after osteosarcoma. Different chemotherapeutic regimens are used in treatment of relapsed/recurrent Ewing sarcoma. Promising results were achieved with combination of irinotecan and temozolomide. Our case was a 13-year-old female with relapsed Ewing sarcoma and after 12 cycles of irinotecan (20 mg/m2/10 days) and temozolomide (100mg/m2/5 days) treatment she had not any complaints, and her radiological lesions remained stable for 66 months. Irinotecan and temozolomide have been used successfully in treatment of relapsed/recurrent Ewing sarcoma, but there is a need for randomized prospective studies with larger patient groups for establishing the efficacy of this treatment protocol

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Ewing J. Classics in oncology. Diffuse endothelioma of bone. James Ewing. Proceedings of the New York Pathological Society, 1921. CA Cancer J Clin. 1972;22:95-8.
Esiashvili N, Goodman M, Marcus RB Jr. Changes in incidence and survival of Ewing sarcoma patients over the past 3 decades: Surveillance Epidemiology and End Results data. J Pediatr Hematol Oncol. 2008;30:425-30.
Smith MA, Gurney JG, Ries LA, Smith MAS, Gurney JG et al. Cancer in adolescents 15 to 19 years old. In: Cancer incidence and Survival Among Children and Adolescents: United States SEER Program 1975-1995, SEER program, National Cancer Institute, Bethesda MD 1999.
Ludwig JA. Ewing sarcoma: historical perspectives, current state-of-the-art, and opportunities for targeted therapy in the future. Curr Opin Oncol. 2008;20:412-8.
Casey DA, Wexler LH, Merchant MS, Chou AJ, Merola PR, Price AP et al. Irinotecan and temozolomide for Ewing sarcoma: the Memorial Sloan-Kettering experience. Pediatr Blood Cancer. 2009;53:1029-34.
Leavey PJ, Mascarenhas L, Marina N, Chen Z, Krailo M, Miser J et al. Prognostic factors for patients with Ewing sarcoma (EWS) at first recurrence following multi-modality therapy: A report from the Children's Oncology Group. Pediatr Blood Cancer. 2008;51:334-8.
Bacci G, Ferrari S, Longhi A, Donati D, De Paolis M, Forni C et al. Therapy and survival after recurrence of Ewing's tumors: the Rizzoli experience in 195 patients treated with adjuvant and neoadjuvant chemotherapy from 1979 to 1997. Ann Oncol. 2003;14:1654-9.
Pizo P, Poplack D. Ewing's sarcoma of bone and soft tissue: principles and practice of pediatric oncology. 3rd ed. Philadelphia: JB Lippincott; 1996;840-1.
Cotterill SJ, Ahrens S, Paulussen M, Jürgens HF, Voûte PA, Gadnerand H et al. Prognostic factors in Ewing's tumor of bone: analysis of 975 patients from the European Intergroup Cooperative Ewing's Sarcoma Study Group. J Clin Oncol. 2000;18:3108- 14.
Pinkerton CR, Bataillard A, Guillo S, Oberlin O, Fervers B, Philip T. Treatment strategies for metastatic Ewing's sarcoma. Eur J Cancer. 2001;37:1338-44.
Grier HE, Krailo MD, Tarbell NJ, Link MP, Fryer CJ, Pritchard DJ et al. Addition of ifosfamide and etoposide to standard chemotherapy for Ewing's sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med. 2003;348:694-701.
Fuchs B, Valenzuela RG, Inwards C, Sim FH, Rock MG. Complications in long-term survivors of Ewing sarcoma. Cancer. 2003;98:2687-92.
Reardon DA, Quinn JA, Rich JN, Desjardins A, Vredenburgh J, Gururangan S et al. Phase I trial of irinotecan plus temozolomide in adults with recurrent malignant glioma. Cancer. 2005;104:1478- 86.
Wagner LM, Crews KR, Iacono LC, Houghton PJ, Fuller CE, McCarville MB et al. . Phase I trial of temozolomide and protracted irinotecan in pediatric patients with refractory solid tumors. Clin Cancer Res. 2004;10:840-8.
Wagner LM, McAllister N, Goldsby RE, Rausen AR, McNall-Knapp RY, McCarville MB et al.. Temozolomide and intravenous irinotecan for treatment of advanced Ewing sarcoma. Pediatr Blood Cancer. 2007;48:132-9. .