Abstract 122P
Background
Ewing sarcoma is a rare highly aggressive malignancy occurring in children and young adolescents. Treatment is multimodal including chemotherapy, surgery with or without radiotherapy. The VDC/IE regimen demonstrated superiority over the VIDE regimen in the EuroEwing12 trial. We aim to compare our local experience with both regimens.
Methods
A retrospective study was conducted in the Medical Oncology Unit of Salah Azaiz Institute including patients diagnosed with Ewing sarcoma treated with either regimen over the period from 2002 to 2023.
Results
Seventy patients were included: 51 males (72.9%), 19 females (27.1%). Median age was 17 years old (range 5-47). Tumor location was dominated by the lower limbs representing 45.7% (n=32), followed by pelvis (21.4%, n=15). Soft tissue tumors were observed in 3 patients (4.3%). Disease at diagnosis was localized in 85.7% of the cases and metastatic in 14.3% with mainly pulmonary lesions (80%). Induction chemotherapy (ICT) was based on the VDC/IE regimen in 20 patients (28.6) and VIDE in 50 (71.4%). Complete surgery was performed in 90% of the cases. After ICT, progressive disease was observed in 5% and 20% of patients receiving VDC/IE and VIDE, respectively. Mean percentage of viable tumor cells was 7.29% after VDC/IE versus 32.7% after VIDE (p=0.006). Good pathological response was observed in 66.7% of the VDC/IE arm and in 41.3% of the VIDE arm with no significant difference (p=0.088). Grade 4 toxicity rate was 52.63% in the VDC/IE arm and 59.18% in the VIDE arm (p=0.624). Median OS was 32 months in the VDC/IE arm versus 39 months in the VIDE arm (p=0.963). Relapse, local or metastatic, was observed in 50% and 34% of each arm, respectively (p=0.282), with a median PFS of 14 months and 57 months for each arm, respectively (p=0.073; HR=0.459; 95%CI [0.196-1.076]). Salvage chemotherapy was based on Irinotecan with Temozolomide or Cisplatin in 68.9% of the cases. After a mean follow-up of 22.3 months, 40% of patients have died after VDC/IE and 42% after VIDE.
Conclusions
In contrast to available data, VDC/IE and VIDE are equally effective in our real-life experience, with no significant difference in treatment tolerance. This could be explained with the smaller size of the sample and the non-availability of stem-cell transplant for very high-risk patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.