PURPOSE: The impact of the modality used for local control of Ewing sarcoma is uncertain. We investigated the relationship between the type of local control modality, surgery, radiation (RT) or both (S + RT), and subsequent risk for local failure (LF) in patients with nonmetastatic pelvic Ewing sarcoma treated on INT-0091. PATIENTS AND METHODS: Patients < or = 30 years with Ewing sarcoma, primitive neuroectodermal tumor or primitive sarcoma of bone were randomly assigned to receive chemotherapy with doxorubicin, vincristine, cyclophosphamide, and dactinomycin, (VACA) or with these four drugs alternating with ifosfamide and etoposide (VACA-IE). The local control modality, surgery, RT or both was chosen by the treating physicians. The effect of local control modality was assessed after adjusting for the size of tumor (< 8 cm, > or = 8 cm) and chemotherapy type. RESULTS:Seventy-five patients with pelvic tumors and a median follow-up of 4.4 years (0.6 to 11.4 years) comprised the study population. Twelve underwent surgery, 44 received RT, and 19 received both. The 5-year event-free survival (EFS) and cumulative incidence of LF was 49% and 21% (16%, LF only; 5%, LF and distant failure). There was no significant difference in EFS or LF by tumor size (< 8 cm, > or = 8 cm), local control (LC) modality, or chemotherapy. However, VACA-IE seems to confer an LC benefit (11% v 30%; P = .06). CONCLUSION: There was no significant effect of local control modality (surgery, RT or S + RT) selected by the treating physicians on rates of local failure or EFS. However, VACA-IE improves LC (11%) compared with previously published results for pelvic Ewing sarcoma.
RCT Entities:
PURPOSE: The impact of the modality used for local control of Ewing sarcoma is uncertain. We investigated the relationship between the type of local control modality, surgery, radiation (RT) or both (S + RT), and subsequent risk for local failure (LF) in patients with nonmetastatic pelvic Ewing sarcoma treated on INT-0091. PATIENTS AND METHODS: Patients < or = 30 years with Ewing sarcoma, primitive neuroectodermal tumor or primitive sarcoma of bone were randomly assigned to receive chemotherapy with doxorubicin, vincristine, cyclophosphamide, and dactinomycin, (VACA) or with these four drugs alternating with ifosfamide and etoposide (VACA-IE). The local control modality, surgery, RT or both was chosen by the treating physicians. The effect of local control modality was assessed after adjusting for the size of tumor (< 8 cm, > or = 8 cm) and chemotherapy type. RESULTS: Seventy-five patients with pelvic tumors and a median follow-up of 4.4 years (0.6 to 11.4 years) comprised the study population. Twelve underwent surgery, 44 received RT, and 19 received both. The 5-year event-free survival (EFS) and cumulative incidence of LF was 49% and 21% (16%, LF only; 5%, LF and distant failure). There was no significant difference in EFS or LF by tumor size (< 8 cm, > or = 8 cm), local control (LC) modality, or chemotherapy. However, VACA-IE seems to confer an LC benefit (11% v 30%; P = .06). CONCLUSION: There was no significant effect of local control modality (surgery, RT or S + RT) selected by the treating physicians on rates of local failure or EFS. However, VACA-IE improves LC (11%) compared with previously published results for pelvic Ewing sarcoma.
Authors: Bradley J Stish; Safia K Ahmed; Peter S Rose; Carola A Arndt; Nadia N Laack Journal: Pediatr Blood Cancer Date: 2015-08-14 Impact factor: 3.167
Authors: Steven G DuBois; Mark D Krailo; Mark C Gebhardt; Sarah S Donaldson; Karen J Marcus; John Dormans; Robert C Shamberger; Scott Sailer; Richard W Nicholas; John H Healey; Nancy J Tarbell; R Lor Randall; Meenakshi Devidas; James S Meyer; Linda Granowetter; Richard B Womer; Mark Bernstein; Neyssa Marina; Holcombe E Grier Journal: Cancer Date: 2014-09-23 Impact factor: 6.860
Authors: Scott C Borinstein; Donald A Barkauskas; Mark Krailo; Daniel Scher; Lauren Scher; Silke Schlottmann; Bhaskar Kallakury; Paul S Dickman; Bruce R Pawel; Daniel C West; Richard B Womer; Jeffrey A Toretsky Journal: Cancer Date: 2011-04-08 Impact factor: 6.860
Authors: Waseem Khaliq; Mohammad Farshad Bahador; Thomas Nichols Laurence; Ronald Andrew Sapiente; James Sheridan Lewis; David Lee Graham Journal: Oncol Lett Date: 2011-10-13 Impact factor: 2.967
Authors: Thomas E Merchant; David Hodgson; Nadia N I Laack; Suzanne Wolden; Danny J Indelicato; John A Kalapurakal Journal: Pediatr Blood Cancer Date: 2012-12-19 Impact factor: 3.167
Authors: Patrick J Leavey; Leo Mascarenhas; Neyssa Marina; Zhengjia Chen; Mark Krailo; James Miser; Ken Brown; Nancy Tarbell; Mark L Bernstein; Linda Granowetter; Mark Gebhardt; Holcombe E Grier Journal: Pediatr Blood Cancer Date: 2008-09 Impact factor: 3.167