Ewing Sarcoma Treatment

Ewing sarcoma is a cancerous tumor. It starts in the bone, often the leg, pelvis, ribs, arm, or spine. In about 1/3 of patients with Ewing sarcoma, the cancer has already spread to the lungs, lymph nodes, bones, or bone marrow by the time it is diagnosed. Ewing sarcoma can grow in the tissue around the bones (the soft tissue). But this is rare.

Ewing sarcoma is the second most common type of bone cancer in children. Of those with Ewing sarcoma:

• About 50% (1 in 2) of all Ewing sarcoma tumors are in children and young adults ages 10–20.
• It affects slightly more boys than girls.
  
• It is rarely found in African Americans and Asian Americans.
• It does not seem to be inherited (passed down in families).
• Ewing sarcoma can occur as a second cancer, especially in patients treated with radiation therapy. But this is uncommon.

Learn more about Ewing sarcoma on the Together by St. Jude™ online resource.

Treatment of Ewing sarcoma

Your child’s care team will likely use several things to treat Ewing sarcoma:

• Chemotherapy ("chemo") to kill cancer cells or stop them from growing (dividing) and making more cancer cells.
• Surgery to remove as much of the tumor as possible
  • Sometimes surgeons will graft (add on) bone or tissue. These grafts replace diseased bone and tissue that have been removed.
  • An artificial bone, called an implant, may also be used.
  • Limb-sparing surgery may be used. During this surgery, the bone is replaced with a prosthesis.
  • For some patients, amputation (the surgical removal of an arm or leg) is needed. This makes sure the tumor is completely removed.
• Radiation therapy to kill or decrease cancer cells that cannot be removed surgically. This therapy is usually followed by more chemo to kill any remaining cells.

Ewing sarcoma clinical trials

St. Jude offers clinical trials and cancer research studies for children, teens, and young adults with Ewing sarcoma and other solid tumors. Learn more about clinical research at St. Jude.

Ewing sarcoma care at St. Jude

St. Jude provides the highest quality of care for patients with Ewing sarcoma:

• St. Jude researchers identified important drug combinations that target the Ewing sarcoma tumor cell’s inability to repair DNA. If the tumor cell cannot repair DNA, then it dies. These treatments, administered on a trial called BMNIRN, were evaluated in patients with relapsed Ewing sarcoma. We found that some patients with relapsed Ewing sarcoma respond to therapy.
  
• St. Jude researchers are conducting a clinical trial called ONITT that targets the Ewing sarcoma cell’s vulnerability. ONITT is a phase 1 / 2 study of Onivyde along  with talazoparib or temozolomide in children and young adults with recurrent or refractory solid tumors and Ewing sarcoma. The ONITT study is an international St. Jude–led study that is open at different sites across North America.
• Radiation treatments, such as intensity-modulated radiation therapy (IMRT) and proton beam radiation therapy, deliver focused radiation to the tumor. They also limit the amount of radiation to normal surrounding tissues. This decreases the side effects related to radiation treatment.
• St. Jude has a team of experts who pioneered limb-salvage procedures (surgery) in children with bone tumors, such as Ewing sarcoma. Limb salvage surgeries allow the surgeon to remove the disease in the bone and replace the bone with a prosthesis. This procedure allows the patient to keep the rest of their limb (leg or arm).
• Imaging techniques allow St. Jude to better define the effects of treatment in children with Ewing sarcoma. These techniques include contrast-enhanced ultrasound and diffuse weighted imaging MRI.

More reasons to choose St. Jude for care include:

• We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report. 
• At St. Jude, we have created an environment where children can be children and families can be together. 
• We lead more clinical trials for childhood cancer than any other hospital in the U.S. 
• St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develops new and better approaches to prevent, diagnose, and treat cancer. 
• The nurse-to-patient ratio at St. Jude is unmatched. It is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit. 
• Patients may be able to get expert, compassionate care and treatment closer to their homes through the St. Jude Affiliate Program.