High-Dose Melphalan, Etopos ide, Tota l-Body Irradiat ion, and Autologous Stem-Cel l Reconst i tut ion as Consol idat ion Therapy for High-Risk Ewing ’s Sarcoma Does Not Improve Prognosis

Purpose: To determine whether consolidation ther-apy with high-dose melphalan, etoposide, and total-body irradiation (TBI) with autologous stem-cell support would improve the prognosis for patients with newly diagnosed metastatic Ewing’s sarcoma (ES). Patients and Methods: Thirty-two eligible patients with newly diagnosed ES metastatic to bone and/or bone marrow were enrolled onto this study. Treatment was initially comprised of five cycles of induction che-motherapy (cyclophosphamide, doxorubicin, and vin-cristine alternating with ifosfamide and etoposide) and local control. Peripheral-blood stem-cell collection was performed after the second cycle of chemotherapy, with delay if the bone marrow was persistently in-volved. If patients had a good response to initial ther