Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2019
High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases: Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 69 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Observational Study on Treatment of Skeletal Ewing Sarcoma at Diagnosis
Evaluation of the Efficacy and Safety of Regorafenib in Patients With Refractory Primary Bone Tumors
Who cites it
69 citing papers in PubMed, 5 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Clinical practice guidelines for the treatment of Ewing sarcoma (Spanish Sarcoma Research Group-GEIS).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Guideline
- Biological Sample Collection to Advance Research and Treatment: A Fight Osteosarcoma Through European Research and Euro Ewing Consortium Statement.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Guideline
- High-dose chemotherapy followed by autologous haematopoietic cell transplantation for children, adolescents, and young adults with first recurrence of Ewing sarcoma.The Cochrane database of systematic reviews · 2021Pooled it
- High-dose chemotherapy followed by autologous haematopoietic cell transplantation for children, adolescents, and young adults with primary metastatic Ewing sarcoma.The Cochrane database of systematic reviews · 2021Pooled it
- Systematic review of phase-I/II trials enrolling refractory and recurrent Ewing sarcoma: Actual knowledge and future directions to optimize the research.Cancer medicine · 2021Pooled it
- Impact of age on safety of Busulfan-Melphalan followed by autologous hematopoietic stem-cell transplantation versus standard chemotherapy in the patients of the EURO-E.W.I.N.G. 99 and Ewing 2008 clinical trials.European journal of cancer (Oxford, England : 1990) · 2024Trial
- Randomized Phase III Trial of Ganitumab With Interval-Compressed Chemotherapy for Patients With Newly Diagnosed Metastatic Ewing Sarcoma: A Report From the Children's Oncology Group.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- [Long-term results of the euro-Ewing99-study].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Article
- Long-Term Analysis of Patients With Ewing Sarcoma Included in the Euro-EWING99 Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Article
- Metastatic Ewing Sarcoma, Patterns of Care and Outcomes of Patients in a Real-Life National Setting Over a Decade.Cancer medicine · 2026Observational
- Sarcomas in Adolescents and Young Adults.Current oncology reports · 2026Review
- Whole Lung Irradiation in Ewing Sarcoma with Pulmonary Metastases: Critical Appraisal of Evolution, Evidence, and Future Pathways in Precision Oncology.Current treatment options in oncology · 2026Review
- Multifunctional nanoplatforms deciphering immune resistance in bone tumors: cooperative delivery, immune reprogramming and microenvironment remodeling.Journal of nanobiotechnology · 2026Review
- Deep learning ensemble models for CT-based differentiation of malignant and benign sacral bone tumors: development and evaluation.Insights into imaging · 2026Article
- Bone and soft tissue sarcoma mortality in 19 811 patients diagnosed in Japan, 2006-2020.JNCI cancer spectrum · 2026Article
- Interval-compressed chemotherapy in patients with Ewing's sarcoma: report on feasibility and toxicity from a North African center.Frontiers in oncology · 2026Article
- Ewing sarcoma of the first metacarpal: a rare case report with thumb-sparing resection and fibular graft reconstruction.Frontiers in surgery · 2026Article
- The Efficacy of High-Dose Chemotherapy Followed by Autologous Stem Cell Transplantation in Ewing Sarcoma Patients.Journal of clinical medicine · 2025Article
- Off-label Use of Dinutuximab Beta in Combination With Chemotherapy in Patients With Ewing Sarcoma: A Retrospective Single-center Case Series.Journal of pediatric hematology/oncology · 2025Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
43 authors at 20 institutions in 12 countries.
Funding
Abstract
purposeThe R2Pulm trial was conducted to evaluate the effect of busulfan-melphalan high-dose chemotherapy with autologous stem-cell rescue (BuMel) without whole-lung irradiation (WLI) on event-free survival (main end point) and overall survival, compared with standard chemotherapy with WLI in Ewing sarcoma (ES) presenting with pulmonary and/or pleural metastases.
methodsFrom 2000 to 2015, we enrolled patients younger than 50 years of age with newly diagnosed ES and with only pulmonary or pleural metastases. Patients received chemotherapy with six courses of vincristine, ifosfamide, doxorubicin, and etoposide (VIDE) and one course of vincristine, dactinomycin, and ifosfamide (VAI) before either BuMel or seven courses of VAI and WLI (VAI plus WLI) by randomized assignment. The analysis was conducted as intention to treat. The estimates of the hazard ratio (HR), 95% CI, and
resultsOf 543 potentially eligible patients, 287 were randomly assigned to VAI plus WLI (n = 143) or BuMel (n = 144). Selected patients requiring radiotherapy to an axial primary site were excluded from randomization to avoid excess organ toxicity from interaction between radiotherapy and busulfan. Median follow-up was 8.1 years. We did not observe any significant difference in survival outcomes between treatment groups. Event-free survival was 50.6% versus 56.6% at 3 years and 43.1% versus 52.9% at 8 years, for VAI plus WLI and BuMel patients, respectively, resulting in an HR of 0.79 (95% CI, 0.56 to 1.10;
conclusionIn ES with pulmonary or pleural metastases, there is no clear benefit from BuMel compared with conventional VAI plus WLI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.