Adult Small Roundcell Tumors

The family of small round-cell tumors includes Ewing's sarcomas, primitive neuroectodermal tumors (PNET), rhabdomyosarcomas (RMS), and desmoplastic small round-cell tumors (DSRCT). The results reported to date from high-dose chemotherapy are generally disappointing in RMS, and uniformly dismal in DSRCT.6164 In contrast, results appear encouraging (25-50% long-term EFS rates) in chemotherapy-sensitive high-risk or advanced PNET/Ewing's sarcomas.65 66 The benefit of total body irradiation in this setting, employed in most early studies, has been seriously questioned in recent years.67 In contrast, melphalan appears to be an important agent in HDC for this disease, and there is debate as to the merits of inclusion of busulfan.68

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