{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:14:52Z","timestamp":1788952492778,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA21765"],"award-info":[{"award-number":["CA21765"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA55727"],"award-info":[{"award-number":["CA55727"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Survivors of Ewing sarcoma (EWS) are at significant long\u2010term risk of treatment\u2010 and disease\u2010related complications. The purpose of this study was to characterize long\u2010term outcomes in EWS survivors according to treatment regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five\u2010year survivors of EWS diagnosed between 1970 and 1999 from the Childhood Cancer Survivor Study were included. Late mortality (&gt;5 years from diagnosis), subsequent malignant neoplasms (SMNs), and severe to fatal chronic health conditions (CHCs) by chemotherapy regimen were compared. Patients were compared to siblings via cumulative incidence and proportional hazards models. Standardized mortality ratios (SMRs) compared late mortality between survivors and the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Survivors (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0739) had higher all\u2010cause (SMR,\u00a06.16; 95% CI,\u00a05.36\u20137.05), SMN\u2010related (SMR,\u00a09.24; 95% CI,\u00a06.92\u201312.08), cardiac\u2010related (SMR,\u00a04.53; 95%\u00a0CI,\u00a02.81\u20136.93), and noncardiopulmonary health\u2010related (SMR,\u00a02.04; 95% CI,\u00a01.25\u20133.15) mortality compared with the general population. Compared with siblings (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a05040), survivors had an increased risk of developing CHCs (any: hazard ratio [HR],\u00a05.49; 95% CI,\u00a04.58\u20136.59; cardiovascular: HR,\u00a04.59; 95% CI,\u00a03.67\u20135.74; neurological: HR,\u00a02.82; 95% CI,\u00a01.72\u20134.63; respiratory: HR,\u00a05.37; 95% CI,\u00a02.76\u201310.5; renal: HR,\u00a04.61; 95% CI,\u00a02.26\u20139.40). Between chemotherapy groups within EWS, there were no statistically significant differences in all\u2010cause, SMN\u2010caused, or health\u2010related late mortality and the risk of developing SMNs or CHCs (any, cardiovascular, neurological, or respiratory), except that the vincristine, doxorubicin, and cyclophosphamide (VDC) plus ifosfamide and etoposide (IE) group had a higher risk of renal complications (HR,\u00a02.55; 95% CI,\u00a01.07\u201311.7; 30\u2010year incidence was 0.56% for VDC and 3.2% for VDC\/IE).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No differences in late mortality, SMNs, and most CHCs were observed between patients who received VDC versus VDC\/IE. Aging EWS survivors\u2019 elevated risk of morbidity and mortality underscores the need for lifelong survivorship care and therapies that reduce the risk for late effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70504","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:43:33Z","timestamp":1783010613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcomes of evolving treatment regimens in\u00a0Ewing sarcoma survivors diagnosed 1970\u20131999: A report from the Childhood Cancer Survivor Study"],"prefix":"10.1002","volume":"132","author":[{"given":"Duncan C.","family":"Ramsey","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Oregon Health and Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5994-2604","authenticated-orcid":false,"given":"David S.","family":"Shulman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston Children\u2019s Hospital and Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace C.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Biostatistics St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital\/Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Geiger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Miami  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0476-7001","authenticated-orcid":false,"given":"Kevin","family":"Krull","sequence":"additional","affiliation":[{"name":"Department of Psychology and Biobehavioral Sciences St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6747-0355","authenticated-orcid":false,"given":"Andrew J.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of General Pediatric Surgery St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten K.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4106-6172","authenticated-orcid":false,"given":"Lucie M.","family":"Turcotte","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Raskin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital\/Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deo Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Biostatistics St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"Biostatistics St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7712-961X","authenticated-orcid":false,"given":"Eric J.","family":"Chow","sequence":"additional","affiliation":[{"name":"Public Health Sciences Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory T.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent R.","family":"Weil","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children\u2019s Hospital and Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0882-738X","authenticated-orcid":false,"given":"Steven G.","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston Children\u2019s Hospital and Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Weldon","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children\u2019s Hospital and Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31816e22f3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00358"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa020890"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.41.5703"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)01790\u20101"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq278"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30627"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25945"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.159"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20100726\u20109"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/corr.0000000000002243"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(23)00154\u20107"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19840615)53:12<2579::AID\u2010CNCR2820531202>3.0.CO;2\u2010V"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.10.2818"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.7764"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00053"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.1953"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30800\u20109"},{"key":"e_1_2_9_20_1","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE): Version 4.0.National Cancer Institute. Accessed January 1 2026.https:\/\/evs.nci.nih.gov\/ftp1\/CTCAE\/CTCAE_4.03\/Archive\/CTCAE_4.0_2009\u201005\u201029_QuickReference_8.5x11.pdf"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmsa060185"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30537\u20100"},{"key":"e_1_2_9_23_1","first-page":"1227","volume-title":"The Use of Psychological Testing for Treatment Planning and Outcomes Assessment","author":"Ware JE Jr","year":"1999"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700048017"},{"key":"e_1_2_9_25_1","volume-title":"BSI\u00ae 18: Brief Symptom Inventory 18: Administration, Scoring, and Procedures Manual","author":"Derogatis LR","year":"2001"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541\u20100420.2010.01420.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24944"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102006\u201001\u2010023101"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41698\u2010022\u201000307\u20102"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.6226"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.7040"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.05.014"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291723002349"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70504","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70504","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:39:10Z","timestamp":1788950350000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":33,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,7,15]]}},"alternative-id":["10.1002\/cncr.70504"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70504","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"2026-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70504"}}