IESS-I was a landmark multicenter RCT enrolling 342 children with primary nonmetastatic Ewing's sarcoma between 1973–1978 across 74 institutions. It compared three regimens — VAC plus doxorubicin, VAC alone, and VAC plus bilateral pulmonary radiotherapy — to determine the optimal chemotherapy backbone and evaluate prophylactic lung irradiation, with >6-year median follow-up.
This study established the foundation for modern Ewing's sarcoma treatment by proving that doxorubicin-containing regimens are superior to VAC alone.
The prognostic significance of primary tumor location, particularly the poor outcomes with pelvic disease, continues to guide risk stratification and treatment planning.
IESS-I was a landmark multicenter RCT enrolling 342 children with primary nonmetastatic Ewing's sarcoma between 1973–1978 across 74 institutions. It compared three regimens — VAC plus doxorubicin, VAC alone, and VAC plus bilateral pulmonary radiotherapy — to determine the optimal chemotherapy backbone and evaluate prophylactic lung irradiation, with >6-year median follow-up.
This study established the foundation for modern Ewing's sarcoma treatment by proving that doxorubicin-containing regimens are superior to VAC alone.
The prognostic significance of primary tumor location, particularly the poor outcomes with pelvic disease, continues to guide risk stratification and treatment planning.