Munson Health
Ewing's Sarcoma

Back to Document

by Kohnle D

(Peripheral Primitive Neuroectodermal Tumors [PNET]; Ewing's Family of Tumors)



Ewing's sarcoma is a cancerous bone tumor that may occur in any bone in the body. When it occurs in soft tissue, it is called extraosseous sarcoma. The most commonly affected areas include the pelvis, thigh, lower leg, upper arm, and chest wall.
Leg and Pelvic Bones—Common Sarcoma Sites
Leg bones
Copyright © Nucleus Medical Media, Inc.


Treatment involves a combination of chemotherapy, surgery, and radiation. Typically, patients are first treated with chemotherapy for 8-12 weeks, followed by a CT or MRI scan to evaluate the tumor. Depending on the tumor size and location, either surgery or radiation follows. Chemotherapy then resumes for several months after surgery or radiation.


Chemotherapy drugs are used to kill tumor cells. The medications used to treat this tumor include vincristine (Oncovin) , dactinomycin (Actinomycin D), cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), ifosfamide (Ifex), and etoposide (VePesid). Your doctor will prescribe a combination of these drugs to be given over a set time. This usually means every 2-4 weeks for several months.


Surgery may be used to remove the tumor, as well as rebuild the affected bone. Depending on the location of the tumor, a bone graft or prosthesis may be needed. There are special types of prostheses that expand as the bone grows. Sometimes, several surgeries are needed to make sure the limb functions properly.

Radiation Therapy

Radiation therapy uses high-energy x-rays to kill tumor cells. It may be used with surgery or instead of surgery. It is usually given over several weeks and is followed by chemotherapy.

Future Therapy

A combination of high-dose chemotherapy and stem cell transplant is being evaluated at certain cancer centers. This combination therapy is typically used in cases where the tumor is very resistant.


American Cancer Society

National Cancer Institute



About Kids Health

Alberta Human Services



Ewing family of tumors. American Cancer Society website. Available at: Accessed June 24, 2013.

Ewing’s sarcoma. American Academy of Orthopaedic Surgeons website. Available at: Updated September 2011. Accessed June 24, 2013.

Ewing sarcoma. EBSCO DynaMed website. Available at: Available at: Updated May 1, 2013. Accessed June 24, 2013.

Miser ES, Goldsby RE, Chen Z, et al. Treatment of metastatic Ewing’s sarcoma/primitive neuroectodermal tumor of bone: evaluation of increasing the dose intensity of chemotherapy-a report from the children’s oncology group. Pediatric Blood Cancer. 2007;49:894-900.

Sarcomas: Ewing's sarcoma. The University of California, San Francisco Children's Hospital website. Available at: Accessed June 24, 2013.

Solid tumors: Ewing sarcoma family tumors. Disease Information. St. Jude Children's Research Hospital website. Available at: Accessed June 24, 2013.


Revision Information