Title: Treatment of Chemosensitive-Sarcoma Patients with Metastases at Diagnosis: Possible Prognostic Value of Peripheral Blood Stem Cell Transplantation.
Abstract: Although the overall treatment of osteosarcoma, Ewing’s sarcoma and rhabdomyosarcoma has improved, patients with metastases (M1) at diagnosis continue to have poor prognoses. The effects of high-dose chemotherapy and autologous peripheral blood stem cell transplantation (PBSCT) on sarcoma patients at M1 have been reported. Here we assess the results of treatment for 22 M1 patients including osteosarcoma (7), Ewing’s sarcoma (10) and rhabdomyosarcoma (5). Original locations were 12 bony lesions and 10 soft tissues. All patients were treated with systemic chemotherapy; five patients (Ewing’s sarcoma, 3; rhabdomyosarcoma, 2) were treated using high-dose chemotherapy with PBSCT. Most patients were also treated with radiation and/or surgery. The results were DOD 18, CDF 3 and AWD 1. The mean survival time for DOD patients was 14.8 months. All surviving patients were treated using high-dose chemotherapy with PBSCT. None of the patients who received conventional chemotherapy survived. The poor prognoses of M1 sarcoma patients might be improved by high-dose chemotherapy with PBSCT, however, true prognostic value of the treatment should be evaluated by prospective randomized studies.