High dose chemotherapy with peripheral blood stem cell (P.B.S.C.) rescue in metastatic Ewing's sarcoma at diagnosis

9004 Background: Metastates at diagnosis are the worst prognostic factor in Ewing’s sarcoma. To ameliorate the prognosis of patients (pts) with lung-pleural and/or solitary bone metastases, ISG-SSG have designed a trial with high dose chemotherapy (HDCT) and PBSC support. Methods: Since June 1999, 70 pts were registered, median age 15 yrs (2–34), 43 males, 27 females. Sites of primary were pelvis-sacrum in 30%, extremities in 22%, axial in 24%, soft tissue in 10%, others in 14%. Metastatic disease was in the lungs in 83%, pleural in 10%, solitary bone in 7%. The treatment consisted in 4 cycles of induction chemotherapy with VCR 2 mg, ADM 90 mg/ sqm, IFO 3 g /sqm x 3 days (VAI) alternate to CTX 4 g/sqm, Etoposide 200 mg/sqm x 3 days (CE) supported by G-CSF. Harvest of PBSC was planned after the 2° cycle CE. Then the pts. underwent local treatment (surgery and/or radiotherapy) and 4 cycles of VCR 2 mg, ADM 80 mg/sqm, CTX 1200mg/sqm (VAC) alternate to IFO 1800 mg/sqm x 5 days and Etoposide 100 mg/sqm x 3 day...