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Professional paper

Ewing’s sarcoma and physiotherapy as a part of medical treatment in the rehabilitation of oncological patients

Hrvoje Gudlin ; Special hospital for children with neurodevelopmental disorders

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page 51-56

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Ewing’s sarcoma is the third most common primary malignant bone tumor, following osteosarcoma and chondrosarcoma, it is also the second most common malignant bone tumor in children and adolescents, and makes up about 10 to 15% of all primary bone tumors. In most cases, it is localized in the lower extremities (45%), followed by the pelvic region (20%), the upper extremities (13%), the axial skeleton and the ribs (13%) and the face skeleton (2%). The tumor arises in the medullary cavity and spreads through the bone and periosteum to soft tissues. It can be localized or metastatic. Typical simptoms are pain, swelling, telangiectasias, neurological deficits, limited mobility, weakness, tiredness and fever. Diagnostics includes X-ray scanning, CT, MRI, scintigraphy and, for the final diagnosis, biopsy. The treatment consists primarily of polychemotherapy cycles lasting 12-24 weeks, followed by surgery, radiotherapy, chemoradiotherapy or amputation. The 5-year survival rate of patients with localized tumor is about 70% and with metastatic tumor it is about 20-30%. The prognosis is poor for patients with tumor relapse which occurs in 30-40% of the patients. About 30% of the patients with tumor relapse have less than 20% chance of survival.
Nowadays, there is a growing need for physiotherapy and rehabilitation in the treatment of oncological patients, to help them to achieve the highest possible quality of life. Physiotherapy in the treatment of oncological patients starts in the intensive care unit. Physiotherapy in Ewing’s sarcoma treatment plays an important role in the preoperative, postoperative and postamputation period.


Ewing’s sarcoma, rehabilitation, physiotherapy, quality of life

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