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The possible prognostic factors in Ewing sarcoma include, for example, the patient’s age, response to chemotherapy, time to relapse, and disease stage [ 42 ]. The patients have markedly different outcomes and response to therapy. The 5-year overall survival (OS) is 71% in patients who have localized disease, and 23% in patients with distant metastases at the time of diagnosis [ 42 ]. Because of its extremely poor prognosis, chemotherapy is often the initial approach to treating advanced Ewing sarcoma. In patients with advanced disease, a combination of vincristine, doxorubicin, cyclophosphamide, and ifosfamide was administered prior to autologous stem cell transplantation, and the event-free survival at 5 years was 25% [ 42 ]. Ewing sarcoma also metastasizes and localizes to the lungs and bones.
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