This 15 years old guy presented with left scapular mass 3 years ago , labeled as ewing sarcmoma. He was treated with 14 cession of Ifosfamide- base chemotherapy as well as involved field radiation. However, he developed multiple bone metastasis so the protocol shifted to irrinotecane+vincristine and then gemcitabine+ decetaxel due to stable disease. Despite 4 courses of GemDox protocol his bone metastasis have remained unchanged. what do you advise next for this poor guy?
regarding this case, I propose a High dose Methotrexate 8mg/m2 alterning with Ifosfamide (each week) 7 courses
More clinical data than those described here should be considered, but there are records of a low 5-year survival in patients with multiple therapy who do not respond to treatment. That is, it is an advanced disease that leaves the patient without conditions for surgery.
A treatment based on high-dose methotrexate alternated with ifosfamide is an option, but the odds are not favorable and you may fall into therapeutic obstinacy, therefore in some cases, a treatment that limits pain has been chosen, a treatment focused on palliative care and the proximity of care with the family.
Rodrigo Gómez Ayala
E. Borrego-Paredesa,∗, E. Prada-Chamorro et.al. (2017) Sarcoma de Ewing, análisis de supervivencia a los 6 años con terapia multidisciplinar. Revista española de cirugía ortopédica y traumatología, ISSN 1888-4415, Vol. 63, Nº. 2, 2019, págs. 86-94
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