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\begin{document}

\title{Demographics, Outcomes, Prognostic Factors in Adolescent-Adult
Non-metastatic Ewing's Sarcomas- Experience from a Tertiary Cancer
Center in India}



\author[1]{Jyoti Bajpai}%
\author[1]{Goutam Panda}%
\author[1]{Prabhat Bhargava}%
\author[1]{Sujay Srinivas}%
\author[2]{Siddhartha Laskar}%
\author[1]{Sonal Dandekar}%
\author[1]{Smruti Mokal}%
\author[2]{Bharat Rekhi}%
\author[2]{Nehal Khanna}%
\author[1]{Nandini  Menon}%
\author[1]{Vijay Patil}%
\author[1]{Vanita Noronha}%
\author[1]{Amit Joshi}%
\author[1]{Kumar Prabhash}%
\author[2]{Sripad Banavali}%
\author[2]{Sudeep Gupta}%
\affil[1]{Tata Memorial Centre}%
\affil[2]{Tata Memorial Hospital}%


\vspace{-1em}



  
  \date{May 23, 2024}


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\selectlanguage{english}
\begin{abstract}
Background Outcome and toxicity data in adolescent-adult Ewing's Sarcoma
(AA-ES) patients is sparse and merits exploration. Methods
Histopathologically confirmed, non-metastatic AA- ES patients, who
received standard institutional combination chemotherapy regimen
(EFT-2001) comprising of ifosfamide plus etoposide and vincristine,
doxorubicin, plus cyclophosphamide, lasting a total of 12 months between
2013 and 2018, were analyzed for treatment-related toxicities,
event-free survival (EFS) and overall survival (OS). Results There were
235 patients (primary safety cohort, PSC) with median age of 23 (15-61)
years; 159(67.7\%) were males, 155 (65.9\%) had skeletal primary and
114(48.5\%) had extremity tumors. 196(83.4\%) were treatment na\selectlanguage{ngerman}ïve
(primary efficacy cohort, PEC) and of these 119 (60.7\%) had surgery. In
PEC, at a median follow up of 36.4 (IQR 20 -- 55) months, estimated 5
year EFS and OS were 60.9\% (95\% CI 53.1\% - 69.9\%) and 84.5\% (95\%
CI 77.7\% - 91.9\%) respectively. Of these, 158 (80.6\%) complying with
intended treatment, at a median follow up of 39 (IQR 26- 57) months had
an estimated 5 year EFS of 63.1\% (95\% CI 54.8\%-72.6\%). In
multivariable analysis good prognostic factors included, longer
symptom(s) duration (HR=0.93, 95\% CI 0.86-0.994), \selectlanguage{english}[?] 99\% necrosis
(HR=0.30, 95\% CI 0.11-0.77) and treatment completion (HR=0.32, 95\% CI
0.14-0.74). Among PSC, grade 3-4 toxicities were febrile-neutropenia
(119, 50.6\%), anemia (130,55.3\%), peripheral neuropathy (37,15.7\%),
with 3(1.3\%) chemo-toxic deaths . Conclusions The outcomes of AA
non-metastatic ES patients treated with EFT-2001 regimen were comparable
to those reported by others, with acceptable toxicity. This regimen
could be considered a standard-of-care in AA-ES.%
\end{abstract}\selectlanguage{ngerman}%



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