Radiation Treatment for Ewing Sarcoma Family of Tumors in Adult Patients: A Single Institution's Experience Over 40 Years.
Am J Clin Oncol
; 42(5): 421-425, 2019 05.
Article
in En
| MEDLINE
| ID: mdl-30883389
ABSTRACT
PURPOSE/OBJECTIVES:
To report prognostic factors and long-term outcomes in adults with Ewing sarcoma treated with definitive radiotherapy. MATERIALS ANDMETHODS:
We reviewed patients 18 years old and above with nonmetastatic Ewing sarcoma treated with radiotherapy +/- chemotherapy or surgery. Outcomes were stratified by age (30 and above vs. younger than 30 y), soft tissue extension, tumor size (≥8.5 vs. <8.5 cm), tumor location, resection (yes vs. no), and treatment era (1970-1992 vs. 1993-2012). Toxicities were scored using the RTOG criteria.RESULTS:
Fifty-five patients (21 women) were treated with radiotherapy. Average age at diagnosis 26.7 years (38 patients below 30 vs. 17 patients 30 y and above). A total of 43 had soft tissue extension (78%). Median tumor size 8.5 cm. Most tumors were in the pelvis (40%), followed by the lower (27%) and upper (24%) extremities. All but 1 patient received chemotherapy; 13 underwent resection. Median dose 55 Gy. Median follow-up 3.6 years; 17.5 years for living patients. The 5-year overall (OS) and cause-specific survival (CSS) rates were both 46%. OS and CSS rates were unaffected by age (P=0.97), tumor size (P=0.12), or tumor location (P=0.99). Soft tissue extension portended a significantly poorer prognosis for 5-year OS and CSS 37% vs. 82% (with and without, respectively; P=0.04). Patients who underwent resection had improved 5-year OS and CSS 77% vs. 37%, respectively (P=0.01). Patients treated after 1993 had improved 5-year OS 58% vs. 37% (P=0.0264).CONCLUSIONS:
Adult patients with Ewing sarcoma experience similar treatment outcomes regardless of age at diagnosis. Soft tissue extension represents a poor prognostic factor. Aggressive trimodality therapy achieved the highest OS and CSS.
Full text:
1
Database:
MEDLINE
Main subject:
Sarcoma, Ewing
/
Bone Neoplasms
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Neoplasm Recurrence, Local
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
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Female
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Humans
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Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Year:
2019
Type:
Article