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Ewing's Sarcoma treatment

Ewing  sarcoma is a rare type of cancer that occurs in bones or in the soft tissue around the bones. 70 percent of children with Ewing sarcoma are cured.

Symptoms: Pain, swelling, tenderness, bone pain, tiredness, broken bone, weight loss, fever.

Diagnosis: CT scan, MRI, PET, bone scan, biopsy.

Treatment: chemotherapy, surgery, radiation therapy, clinical trials.

MedTour patients recommend clinics for the treatment of Ewing's sarcoma:

Turkey, Istanbul
Medipol University Hospital
5.00
Excellent(5.001 review)
Admission fee:
from 120 USD
Apply
Israel, Tel-Aviv
Sourasky Medical Center (Ichilov Clinic)
5.00
Excellent(5.001 review)
Admission fee:
from 600 USD
Apply
Turkey, Istanbul
LIV Hospitals
5.00
Excellent(5.001 review)
Admission fee:
from 120 USD
Apply
Turkey, Istanbul
Medical Park Hospitals Network
4.67
Excellent(4.676 reviews)
Admission fee:
from 130 USD
Apply
Israel, Haifa
Rambam Medical Center
Admission fee:
To be clarified
Apply
Turkey, Istanbul
Memorial Hospitals
4.22
Excellent(4.229 reviews)
Admission fee:
from 140 USD
Apply
Israel, Tel-Aviv
Assuta Medical Center
5.00
Excellent(5.001 review)
Admission fee:
from 500 USD
Apply
Italy, Milan
San Raffaele Hospital
Admission fee:
from 300 USD
Apply
Germany, Berlin
Helios Hospital Berlin-Buch
3.50
Good(3.502 reviews)
Admission fee:
from 280 USD
Apply
India, Bangalore, Goa
Manipal Hospitals Network
Admission fee:
from 100 USD
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Spain, Barcelona, Madrid
HM Hospitals
Admission fee:
from 300 USD
Apply
Turkey, Istanbul
Hisar Hospital Intercontinental
Admission fee:
from 120 USD
Apply
Republic of Korea, Seoul
Seoul National University Hospital (SNUH)
Admission fee:
from 50 USD
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Spain, Barcelona
Sant Joan de Déu Children’s Hospital
Admission fee:
To be clarified
Apply
Israel, Petah Tikva
Schneider Children’s Medical Center
Admission fee:
To be clarified
Apply
Turkey, Istanbul
Okan University Hospital
Admission fee:
To be clarified
Apply
Israel, Jerusalem
Hadassah Medical Center
5.00
Excellent(5.001 review)
Admission fee:
from 700 USD
Apply
Israel, Ramat Gan
Sheba Medical Center
4.67
Excellent(4.673 reviews)
Admission fee:
from 600 USD
Apply
Israel, Herzliya
Herzliya Medical Center
4.50
Excellent(4.502 reviews)
Admission fee:
from 900 USD
Apply
Rabin Medical Center
Admission fee:
from 800 USD
Apply
20 clinics of 32 Show more

Frequently Asked Questions

1
What is the Ewing's sarcoma

A rare aggressive malignant tumor of bone or soft tissue around bones. Characterized by a high propensity for rapid progression, recurrence and early metastasis.

  • People of 5-30 years old suffer,
  • The peak occurs at 10-15 years,
  • 2nd place in the incidence among bone sarcomas in children,
  • 80% are under 20 years old,
  • Male sex is sick 2-3 times more often,
  • Rarely occurs in people over 30.
1
Why and where does the Ewing's sarcoma occur

The origin is unknown. There’s no reliable information on the influence of environmental factors that could be adjusted to reduce the incidence.

It has been proven that the risk of developing a formation increases in the presence of genetic predisposition, congenital bone anomalies, trauma.

Sarcoma grows from the diaphysis — the place where bone marrow is stored.

In 85-90% of cases, bone lesions, of which:

  • 40% — lower limbs,
  • 26% — pelvic girdle,
  • 16% — chest,
  • Other locations — ridge, skull.

In 10-15%, extraosseous formations arise, which originate from soft tissues and grow along the body structures, for example, around bone, along muscle fibers or blood vessels.

1
Types of Ewing's sarcoma

Tumors of the Ewing sarcoma family include:

  • Classic ES — 80%,
  • Extraosseous, or extraosseous, are formed as close as possible to axial skeleton — in ribs, sacrum, vertebrae — 8%,
  • Askin’s chest tumors — 7%,
  • Peripheral primitive neuroectodermal tumors (PPNEO) — 5%.
1
Survival and prognosis of Ewing's sarcoma

Survival and prognosis for life in patients with Ewing’s sarcoma depend on several factors:

  • Presence of metastases,
  • Volume and location of tumor,
  • Treatment response.

The survival rate is 75-80% if the recommendations of doctors and prescribed therapy are followed. But drops significantly if disease is diagnosed at a late stage.

1
Symptoms of Ewing's sarcoma

Characterized by a triad:

  • Swelling without clear boundaries,
  • Pain,
  • Dysfunction of damaged structure.

Distinctive symptoms that can help diagnose: fever and increased pain at night.

1
How to identify Ewing's sarcoma abroad

Doctors collect information about disease and conduct a physical exam. Mandatory examination methods:

  • General blood test, ultrasound,
  • X-ray, MRI or CT of affected bone and chest.

An additional method used by foreign clinics — positron emission tomography (PET). To detect or exclude metastasis, bone scintigraphy is used. To assess malignancy of growth, a trephine biopsy of bone marrow is performed, followed by a morphological examination of biopsy.

Having received the conclusions of these analyses, the team of doctors chooses tactics of treatment and assesses prognosis for life and health.

1
Treatment options for Ewing's sarcoma abroad

It’s important that the initial assessment of the patient’s condition and biopsy be performed in a center that is experienced in the treatment of such rare tumors. These cancer centers have all the necessary research equipment and multidisciplinary team of doctors, consisting of:

  • Surgeons,
  • Oncologists-radiologists,
  • Pediatric oncologists (for children).

ES is difficult to treat. This requires a lot of medical professionals.

MedTour can meet all these needs when it comes to a team approach to CJ treatment.

Method of choice is systemic treatment in combination with chemotherapy. Treatment outcomes without chemotherapy are extremely low.

Current treatment protocols for Ewing’s sarcoma

Therapy of such tumors requires an integrated approach and should be carried out in specialized centers. Currently, ES in the bones, as well as soft tissue neoplasms, are treated in the same way.

Polychemotherapy (PCT) is combined with radiation therapy (RT) and / or surgery. For patients with spread of metastases, high-dose PCT with subsequent autologous stem cell transplantation is available.

These therapies are practiced:

  • Cycles of PCT,
  • Surgical removal of tumor, if possible,
  • Radiation therapy (RT).

Chemotherapy

Doctor uses powerful drugs to kill cancer cells. Recommended PCT regimens combine 3-5 drugs that are taken by swallowing or intravenous injection. These medicines shrink the neoplasm and make it easier to remove by surgery. After surgery or radiation therapy, chemotherapy is performed again to kill remaining tumor cells. In severe stages, when metastases are spread throughout the body, chemotherapy is used for palliative purposes: it slows down the progression of growth and relieves pain.

Surgical intervention

Her goal — the complete removal of sarcomas. The volume of operation depends on neoplasm size and degree of its transition to adjacent tissues. Procedure involves removing part or all of bone. Organ-preserving interventions are mainly performed. If it wasn’t possible to leave the limb, bone transplantation is performed either with bone material of the patient himself, or from the bone bank, and / or using artificial prostheses (endoprosthetics).

Radiation therapy

Can be recommended after surgery to kill remaining cancer cells or instead of surgery if ES is located in a part of the body where surgery is not possible.

RT indications:

  • Impossibility of surgical removal of neoplasm,
  • Preservation of >10% of viable tumor cells after surgery,
  • Treatment metastasis foci;

General principles of LT:

  • MedTour experts recommended to conduct radiation therapy in the oncological center, where systemic and surgical treatment was carried out for close interaction of the team of doctors,
  • It’s also recommended to use modern technology radiotherapy — IMRT, therapy and stereotactic radiosurgery particles. Leading foreign clinics use these techniques. Since they irradiate a strictly limited area as accurately as possible, they have fewer side effects and minimize radiation from healthy tissues.

Published:

Updated:

Ilona Baidiuk
Medical author:
PhD. Olexandr Voznyak
Medical expert:
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