Twelve patients with metastatic Ewing's sarcoma, ranging in age from 4 to 26 years, were treated with l-3-bis chloroethyl nitrosourea (BCNU). The tumor in five of the patients showed objective tumor shrinkage with BCNU. In one patient, there was complete disappearance of the tumor lasting 2% years. In four other patients, there was partial improvement (50% shrinkage) lasting 2, 3, 6, and 8 months. BCNU may be of value in an adjuvant chemotherapy program as part of the initial treatment in an attempt to eradicate subclinical micrometastasis and thus increase the cure rate.
WING'S SARCOMA IS AN UNCOMMON, HIGHLY
E malignant tumor of bone seen predominantly in teenage children and young adults. Because of the relative rarity of the disease, information on the treatment of disseminated disease by various chemotherapeutic agents is restricted to a small number of cases. Nonetheless, it appears that certain agents such as cyclophosphamide, vincristine, 5-fluorouracil, and acetylenic carbamate can induce objective tumor regressions in metastatic Ewing's sarc ~m a . ~J + -~o However, these regressions are not permanent and, in fact, frequently are of very short duration.
Knowledge of the efficacy of 1-3-bis chloroethyl nitrosourea (BCNU) in Ewing's tumor is extremely limited. Devita et a1.2 reported a complete tumor regression for more than 63 days using BCNU in a patient with Ewing's sarcoma. Iriarte et aLG also reported tumor regression of Ewing's sarcoma in two children using BCNU for metastatic disease. Since these three patients were all treated at this Institute, a further report on outcome, and a search of our records for other patients has been made. T h e present report extends these observations to 12 patients with metastatic Ewing's tumor treated with BCNU at Roswell Park Memorial Institute.
Methods
Twelve patients with biopsy-proven metastatic Ewing's sarcoma were treated with intra-