The type of chemotherapy given depends on whether the cancer is found only in the place it first formed, has spread to other parts of the body, or has come back after treatment.
Chemotherapy is part of the treatment for all patients with Ewing tumors. It is usually given to kill any tumor cells that have spread to other parts of the body. Chemotherapy may also be given to shrink the tumor before surgery or radiation therapy.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
External radiation therapy is used to treat Ewing sarcoma.
Radiation therapy is used when the tumor cannot be removed by surgery or when surgery to remove the tumor will affect the way the child will look or important body functions. It is used to make the tumor smaller and decrease the amount of tissue that needs to be removed during surgery. It may also be used to treat tumors that have spread to other parts of the body.
Surgery is usually done to remove cancer that is left after chemotherapy or radiation therapy. When possible, the whole tumor is removed by surgery. Tissue and bone that are removed may be replaced with a graft, which uses tissue and bone taken from another part of the patient's body or a donor. Sometimes an implant, such as artificial bone, is used.
Even if the doctor removes all of the cancer that can be seen at the time of the operation, chemotherapy or radiation therapy may be given after surgery to kill any cancer cells that are left. Chemotherapy or radiation therapy given after surgery to lower the risk that the cancer will come back is called adjuvant therapy.