Carboplatin is an effective alternative to actinomycin-D as part of consolidation therapy for pediatric patients with Ewing sarcoma (ES), according to research published in the Journal of Bone Oncology

To compare the drugs, researchers conducted a retrospective study of 82 patients diagnosed with ES between 2005 and 2020.

All patients received standard induction with vincristine, ifosfamide, doxorubicin, and etoposide. Before 2013, patients received vincristine, actinomycin-D, and cyclophosphamide as consolidation therapy. As of 2013, the actinomycin-D has been replaced with carboplatin.

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In all, 22 patients were treated with actinomycin-D, 32 received carboplatin, and 24 did not receive any consolidation therapy. 

For the whole group, the 5-year overall survival (OS) rate was 46%, and the 10-year OS rate was 40%. The 5-year OS rate was twice as high in patients with localized disease as in those with metastatic disease (54% vs 26%; P =.006). 

There was no significant difference in OS before and after 2013 (P =.798) or between patients who received carboplatin and those who received actinomycin-D (P =.856). However, OS was significantly worse for patients who did not receive any consolidation treatment (P =.002).

The 5-year OS rate was 50% for patients treated with actinomycin-D, 58% for those who received carboplatin, and 20% for those who did not receive any consolidation. The 10-year OS rate was 50% with actinomycin-D and 20% without consolidation. Ten-year OS data were not available for the carboplatin group. 

“The results of the present study showed that carboplatin could be effectively used as an alternative to actinomycin-D in the maintenance treatment of ES,” the researchers concluded.


Ozkan A, Bayram I, Sezgin G, Mirioglu A, Kupeli S. Efficacy of replacing actinomycin-D with carboplatin in Ewing sarcoma consolidation treatment: Single-center experience. J Bone Oncol. 2022;35:100435. doi: 10.1016/j.jbo.2022.100435