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Radiation Treatment for Ewing Sarcoma Family of Tumors in Adult Patients: A Single Institution's Experience Over 40 Years.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2019 May; Vol. 42 (5), pp. 421-425. - Publication Year :
- 2019
-
Abstract
- Purpose/objectives: To report prognostic factors and long-term outcomes in adults with Ewing sarcoma treated with definitive radiotherapy.<br />Materials and Methods: 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.<br />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).<br />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.
- Subjects :
- Academic Medical Centers
Adolescent
Adult
Bone Neoplasms pathology
Bone Neoplasms surgery
Chemotherapy, Adjuvant
Cohort Studies
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local therapy
Orthopedic Procedures methods
Prognosis
Radiotherapy Dosage
Radiotherapy, Adjuvant
Retrospective Studies
Risk Assessment
Sarcoma, Ewing pathology
Sarcoma, Ewing surgery
Statistics, Nonparametric
Survival Analysis
Treatment Outcome
United States
Young Adult
Bone Neoplasms mortality
Bone Neoplasms radiotherapy
Neoplasm Recurrence, Local mortality
Sarcoma, Ewing mortality
Sarcoma, Ewing radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 42
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30883389
- Full Text :
- https://doi.org/10.1097/COC.0000000000000532