Treatment of patients aged over 50 years with non-osseous Ewing's sarcoma family tumors: five cases and review of literature.

BACKGROUND: Most clinical trials on Ewing's sarcoma family of tumors include pediatric and adolescent populations, whereas clinical data on older patients are limited. PATIENTS AND METHODS: We report on 5 patients older than 50 years with a tumor of the Ewing's sarcoma family treated recently in our department. RESULTS: Myelosuppression and infectious complications were the main toxicity encountered. Major dose reductions and/or treatment delays were required in all 5 patients. One patient died of septic shock. Complete remission was achieved in the remaining 4 patients with the addition of different treatment modalities. One patient had lung metastasis 3 years after starting chemotherapy, and 3 patients have remained without evidence of recurrent disease for 1-6 years from the onset of chemotherapy CONCLUSIONS: There is no definite answer as to whether older age is a poor prognostic factor in patients with a tumor of the Ewing's sarcoma family. In our experience, patients over 50 poorly tolerated the standard chemotherapy protocol used in the pediatric population.

Surrogate versus couple therapy in vaginismus.

INTRODUCTION: Women who do not have a cooperative partner cannot complete the usual therapeutic process in the treatment of vaginismus, because they cannot progress to the stage of practicing the insertion of the man partner's fingers and the insertion of a penis. AIM: To compare traditional couple therapy with therapy utilizing a surrogate partner. METHODS: The study was controlled and retrospective. Data were obtained from the treatment charts of patients who had come to the clinic for treatment of vaginismus. Sixteen vaginismus patients who were treated with a man surrogate partner were compared with 16 vaginismus patients who were treated with their own partners. MAIN OUTCOME MEASURES: Successful pain-free intercourse upon completion of therapy. RESULTS: One hundred percent of the surrogate patients succeeded in penile-vaginal intercourse compared with 75% in the couples group (P = 0.1). All surrogate patients ended the therapy because it was fully successful, compared with 69% in the couples group. Twelve percent of the couples group ended the therapy because it failed, and 19% because the couples decided to separate. CONCLUSIONS: Treating vaginismus with a man surrogate partner was at least as effective as couple therapy. Surrogate therapy may be considered for vaginismus patients who have no cooperative partner.