What is the impact of local control in Ewing sarcoma: Analysis of the first Brazilian collaborative study group - EWING

Made available in DSpace on 2018-12-11T17:14:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-01-01 Background: Relapse in localized Ewing sarcoma patients has been a matter of concern regarding poor prognosis. Therefore, we investigated the impact of local control modality (surgery, surgery plus radiotherapy, and radiotherapy) on clinical outcomes such as survival and recurrence in patients with non-metastatic Ewing sarcoma treated on the first Brazilian Collaborative Group Trial of the Ewing Family of Tumors (EWING1). Methods: Seventy-three patients with localized Ewing sarcoma of bone aged < 30 years were included. The treating physicians defined the modality of local control based on the recommendations of the coordinating center and the patient and tumor characteristics. Possible associations of local control modality with local failure (LF), disease-free survival (DFS), event-free survival (EFS), overall survival (OS), and clinical characteristics were analyzed. Results: Mean patient age was 12.8 years (range, 2 to 25 years) and median follow-up time was 4.5 years (range, 2. 3 to 6.7 years). Forty-seven patients underwent surgery, 13 received radiotherapy, and 13 received both. The 5-year EFS, OS, and DFS for all patients was 62.1%, 63.3%, and 73.1%, respectively. The 5-year cumulative incidence (CI) of LF was 7.6% for surgery, 11.1% for radiotherapy, and 0% for postoperative radiotherapy (PORT) (p = 0.61). The 5-year EFS was 71.7% for surgery, 30.8% for radiotherapy, and 64.1% for PORT (p = 0.009). Conclusions: There was a significant effect of local control modality on EFS and OS in the study. Surgery and PORT modalities yielded very close results. The group treated with radiotherapy alone had considerably worse outcomes. This may be confounded by greater risk factors in these patients. There was no significant effect of local control modality on the CI of LF and DFS. Service of Orthopedics and Traumatology Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Bairro Santa Cecilia Department of Pediatrics HCPA Universidade Federal do Rio Grande do Sul (UFRGS) Department of Pediatrics Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Service of Orthopedics and Traumatology HCPA Support Group for Children and Adolescents with Cancer (GRAACC) Universidade Federal de São Paulo (UNIFESP) Fundação Pio XII Hospital de Câncer Infantojuvenil Centro Hospitalario Pereira Rossell Orthopedics Service Hospital A.C. Camargo Cancer Center Service of Orthopedics and Traumatology Santa Casa de Misericórdia de Porto Alegre Orthopedic Trauma Institute Hospital das Clínicas de São Paulo School of Medicine Universidade de São Paulo (USP) Department of Orthopedics and Traumatology Santa Casa de Misericórdia de São Paulo (HSCSP) Service of Orthopedics and Traumatology Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Hospital das Clínicas deBotucatu School of Medicine Universidade Estadual Paulista (UNESP) Instituto do Câncer Infantil Hospital das Clínicas deBotucatu School of Medicine Universidade Estadual Paulista (UNESP)