Arnold C Paulino1, Wei Y Mai, Bin S Teh. 1. Department of Radiation Oncology, The Methodist Hospital, Houston, TX 77030, USA. apaulino@tmhs.org
Abstract
OBJECTIVE: To review an institutional experience with radiotherapy (RT) in patients with metastatic Ewing sarcoma. METHODS: Thirty patients with metastatic Ewing sarcoma were considered. Twenty-nine received multiagent chemotherapy, whereas 22 had local therapy, which included RT in 14, surgery in 5, and surgery followed by RT in 3. RESULTS: The 5-year overall survival rate was 22.1%. On multivariate analysis, presence of uncommon sites of metastasis (brain, liver, spleen) (P<0.0001) and use of local therapy to the primary site (P<0.001) were adverse factors for survival. Local control was not achieved in the 8 patients receiving only chemotherapy. All long-term survivors had local therapy including RT to metastatic bony sites and whole-lung irradiation for pulmonary metastasis. CONCLUSIONS: The presence of uncommon sites of metastasis confers a worse prognosis. Aggressive primary treatment including RT to metastatic sites should be considered in these patients.
OBJECTIVE: To review an institutional experience with radiotherapy (RT) in patients with metastatic Ewing sarcoma. METHODS: Thirty patients with metastatic Ewing sarcoma were considered. Twenty-nine received multiagent chemotherapy, whereas 22 had local therapy, which included RT in 14, surgery in 5, and surgery followed by RT in 3. RESULTS: The 5-year overall survival rate was 22.1%. On multivariate analysis, presence of uncommon sites of metastasis (brain, liver, spleen) (P<0.0001) and use of local therapy to the primary site (P<0.001) were adverse factors for survival. Local control was not achieved in the 8 patients receiving only chemotherapy. All long-term survivors had local therapy including RT to metastatic bony sites and whole-lung irradiation for pulmonary metastasis. CONCLUSIONS: The presence of uncommon sites of metastasis confers a worse prognosis. Aggressive primary treatment including RT to metastatic sites should be considered in these patients.
Authors: Dana L Casey; Leonard H Wexler; Paul A Meyers; Heather Magnan; Alexander J Chou; Suzanne L Wolden Journal: Pediatr Blood Cancer Date: 2014-10-24 Impact factor: 3.167
Authors: Azeem Tariq Malik; John H Alexander; Joel L Mayerson; Safdar N Khan; Thomas J Scharschmidt Journal: Clin Orthop Relat Res Date: 2020-10 Impact factor: 4.755