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Treatment of Metastatic Ewing Sarcoma
Source: Ewing Sarcoma and Undifferentiated Small Round Cell Sarcomas of Bone and Soft Tissue Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: November 27, 2024 · Captured 2026-09-09.
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Approximately 25% of patients with Ewing sarcoma have metastases at diagnosis.[1] The prognosis is poor for patients with metastatic disease. With current therapies, patients who present with metastatic disease have a 6-year event-free survival (EFS) rate of approximately 28% and an overall survival (OS) rate of approximately 30%.[2,3] For patients with lung/pleural metastases only, the 6-year EFS rate is approximately 40% when using bilateral lung irradiation.[2,4] In contrast, patients with bone/bone marrow metastases have a 4-year EFS rate of approximately 28%, and patients with combined lung and bone/bone marrow metastases have a 4-year EFS rate of approximately 14%.[4,5]
The following factors independently predict a poor outcome in patients presenting with metastatic disease:[3]
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Age older than 14 years.
Primary tumor volume of more than 200 mL.
More than one bone metastatic site.
Bone marrow metastases.
Additional lung metastases.
Pulmonary metastases lack of complete response to induction chemotherapy.[6]
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Standard treatment options for metastatic Ewing sarcoma include the following:
Chemotherapy.
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Surgery.
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Radiation therapy.
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Preserved source evidence · Not medical advice