Adjuvant chemotherapy was added to local radiation therapy for patients with Ewing's sarcoma to treat widespread microfoci of disease presumed to be present at the time of diagnosis. Since June 1970, 12 children have been treated with radiation therapy and sequential adjuvant chemotherapy: dactinomycin, adriamycin, vincristine, and cyclophosphamide, continued for 2 years. Two children developed reversible congestive heart failure after cumulative adriamycin doses of 905 mg/m2 in one patient and 720 mg/m2 in another patient who had mediastinal irradiation. Adriamycin is now generally limited to cumulative doses of 720 mg/m2 but is further limited to 500 mg/m2 in children who receive mediastinal or pulmonary irradiation. Of 12 children entered into this study and followed for from 10 to 37 months, all continue in disease‐free remission without evidence of recurrent tumor, metastatic tumor, or central nervous system disease.

Cardiac metastasis should be strongly suspected in the cancer patient with sudden onset of unexplained tachycardia, arrhythmia, or congestive heart failure. Conduction defects and low voltage on electrocardiographic examination and an enlarged heart shadow on the chest film are virtually confirmatory. Thirty-eight such patients were treated through anterior and posterior opposing portals and received 2,500-3,500 rads in 3-4 weeks, except for 6 lymphoma and leukemia patients who were controlled with lower doses (1,500-2,000 rads in 11/2-2 weeks). Primary sites and duration of improvement were as follows: breast (11/16 patients): 2-36 months; lung (2/7 patients): 1-9 months; lymphoma and leukemia (6/7 patients): 2-4 months; others (4/8 patients): 1-4 months. Overall, the clinical improvement rate was 60%, with durations of 12 to 36 months.

Twenty-nine children under 15 years of age with embryonal rhabdomyosarcoma were treated according to a multidisciplinary protocol (T-2). The protocol consisted of surgical removal of the tumor if possible, followed by chemotherapy, and also with radiation therapy in patients with gross or microscopic residual disease. Radiation therapy was given in the 4500-7000 rads range. The chemotherapy consisted of cycles of sequential administration of dactinomycin, Adriamycin, vincristine, and cyclophosphamide, with obligatory periods of rest. The drug therapy was continued for 2 years. Following surgery, clinicopathologic staging of the disease revealed 10 patients with no residual disease (I-A), 5 with microscopic residual disease (I-B), 5 with unresectable tumors (II), 6 with unresectable tumors plus regional lymph node involvement (III), and 3 with disseminated tumors (IV). Twenty-four (82%) of the patients (20 Stages I-II, 4 Stage III) are alive with no evidence of disease for 4 plus to 42 plus months. These results are superior to those achieved between 1960-1970 among 108 children treated at Memorial Sloan-Kettering Cancer Center.

Between 1929 and September 1974,211 children under 15 years of age with biopsy‐proven Hodgkin's disease were treated at Memorial Sloan‐Kettering Cancer Center. For analysis these patients were placed into three historical groups which displayed the most marked changes in diagnostic workup and therapy. They are as follows: Pre‐1959—80 patients with “clinical” staging, local field radiation therapy, palliative chemotherapy; 1960–1969—86 patients with lymphangiographic staging, extended field radiation therapy, palliative chemotherapy; 1970‐September 1974—45 patients with “contemporary” staging, including laparotomy, involved field radiation therapy, and/or multiple drug chemotherapy. Twenty‐seven children with Stage IV disease at diagnosis or those with recurrent disease received this multiple drug regimen. This consisted of Adriamycin, followed by combined prednisone, procarbazine, and vincristine, then cyclophosphamide. Drug cycles were repeated every 3–4 months for a period of about 24 months. Twenty‐five achieved remission, 20 complete and 5 partial. The median duration of complete remission was 18+ months. This multidisciplinary management of Hodgkin's disease has shown early, encouraging results. Longer followup is needed to determine that this improvement in survival will persist into adulthood.