Combination Chemotherapy in Treating Patients With Non-Metastatic Extracranial Ewing Sarcoma

Inclusion Criteria:

   - Patients with newly diagnosed, biopsy confirmed, extracranial, non-metastatic Ewing
   sarcoma or primitive neuroectodermal tumor (PNET) of bone or soft tissue are eligible
   for this study; note:

      - For the purpose of this study, chest wall tumors with ipsilateral pleural
      effusions, ipsilateral positive pleural fluid cytology or ipsilateral pleural
      based secondary tumor nodules will be considered localized disease

      - Patients with regional node involvement, based on clinical suspicion confirmed by
      pathologic documentation are considered to be non-metastatic

      - Patients with discontinuous osseous lesions within the same bone are considered
      to be non-metastatic

      - Tumors arising in the bony skull (extra-dural) are considered to be extracranial

   - Patient eligibility will be based on a diagnosis of Ewing sarcoma or PNET by
   institutional pathologist

   - No prior chemotherapy or radiation therapy is allowed; patients should only have had a
   biopsy of the primary tumor without an attempt at complete or partial resection;
   patients will still be eligible if unplanned excision was attempted or accomplished as
   long as adequate imaging was obtained prior to surgery

   - Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70mL/min/1.73
   m^2 or serum creatinine based on age/gender as follows:

      - 1 month to < 6 months: 0.4 mg/dL

      - 6 months to < 1 year: 0.5 mg/dL

      - 1 to < 2 years: 0.6 mg/dL

      - 2 to < 6 years: 0.8 mg/dL

      - 6 to < 10 years: 1 mg/dL

      - 10 to < 13 years: 1.2 mg/dL

      - 13 to < 16 years: 1.5 mg/dL (male), 1.4 mg/dL (female)

      - >= 16 years: 1.7 mg/dL (male), 1.4 mg/dL (female)

   - Total bilirubin < 1.5 x upper limit of normal (ULN) for age

   - Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or
   serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 2.5 x
   upper limit of normal (ULN) for age

   - Shortening fraction of >= 27% by echocardiogram, or ejection fraction of >= 50% by
   radionuclide angiogram

Exclusion Criteria:

   - Patients must have no evidence of metastatic disease; metastatic disease are lesions
   which are discontinuous from the primary tumor, are not regional lymph nodes and do
   not share a body cavity with the primary tumor; if there is any doubt whether lesions
   are metastatic, a biopsy of those lesions should be taken

      - Skeletal lesions in adjacent bones (trans-articular)

      - Contralateral pleural effusion and contralateral pleural nodules

      - Distant lymph node involvement

      - Patients with pulmonary nodules are considered to have metastatic disease if the
      patient has:

         - Solitary nodule > 0.5 cm or multiple nodules of > 0.3 cm unless biopsied and
         negative for Ewing's

         - Biopsies of solitary nodule =< 0.5 cm or multiple nodules =< 0.3 cm are not
         required but if performed and positive indicate metastatic disease

   - Patients whose tumors arise in the dural and intra-dural soft tissues of the cranium
   and spine are not eligible

   - Patients with pathologic diagnoses other than Ewing sarcoma will be excluded

   - Patients diagnosed with Ewing Sarcoma as a second malignant neoplasm are not eligible
   if they have received chemotherapy or radiation for the treatment of their primary
   malignancy

   - Pregnant women will not be entered on this study; pregnancy tests must be obtained in
   female patients who are post-menarchal; lactating females may not participate unless
   they have agreed not to breastfeed their infants; males or females of reproductive
   potential may not participate unless they have agreed to use an effective
   contraceptive method for the duration of the study treatment

   - All patients and/or their parents or legal guardians must sign a written informed
   consent

   - All institutional, Food and Drug Administration (FDA), and National Cancer Institute
   (NCI) requirements for human studies must be met