Ew in?

For lethal doses of chemo. The phase 3 R2Loc trial enrolled 240 patients with localized high-risk Ewing sarcoma at a median age of 17 years (range: 1 - 45). “High-risk” was defined here as initial large-volume (>200 mL) disease or a poor response (>10% viable cells on path if resected or <50% radiographic response if not resected) to induction chemo consisting of VIDE x 6. They were then randomized to one of two consolidative chemo regimens: [1] VAI x 7 or [2] the intensified VAI x 1 → high-dose busulfan-melphalan with autologous stem cell rescue. It's an important note that, given the exquisite radiosensitizing power of busulfan, patients expected to receive >30 Gy to the cord or >45 Gy to bowel were excluded. The intensified arm saw significant improvements at 8 years in rates of both event-free (47 → 61%) and overall (56 → 65%) survival. TBL: Dose-intensified consolidative chemo with high-dose busulfan-melphalan improves overall survival for patients with high-risk Ewing sarcoma. | Whelan, J Clin Oncol 2018