The effect of preoperative treatment with radiotherapy and chemotherapy on Ewing's sarcoma.

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Local control of Ewing's sarcoma by preoperative treatment was observed histologically using surgically resected specimens. As preoperative treatment, 3 patients with Ewing's sarcoma in left humerus (case 1), right humerus (case 2) and right ilium (case 3) were treated with low dose irradiation of 30 Gy and combination chemotherapy of vincristine, adriamycin and cyclophosphamide. Wide resections were performed in case 1 and case 2 for limb-salvage, while hemipelvectomy was done in case 3.In the histological examination of the resected specimens, extensive necrosis was seen in the greater part of the tumor of case 1. A thick fibrous capsule making the border clear was newly formed between a small viable tumor cell nest and its surrounding soft tissue. The whole tumors of case 2 and case 3 fell into complete necrosis.These findings seemed to be of use to facilitate the complete excision of Ewing's sarcoma to prevent a local recurrence.
西日本整形・災害外科学会の論文