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. 2011 Mar 12;16(3):103-9.
doi: 10.1016/j.rpor.2011.01.006. eCollection 2011.

Role of radiation therapy in the multidisciplinary management of Ewing's Sarcoma of bone in pediatric patients: An effective treatment for local control

Jose Luis Lopez  1 , Patricia Cabrera  1 , Rafael Ordoñez  1 , Catalina Marquez  2 , Gema Lucia Ramirez  2 , Juan Manuel Praena-Fernandez  3 , Maria Jose Ortiz  1
Affiliations

Role of radiation therapy in the multidisciplinary management of Ewing's Sarcoma of bone in pediatric patients: An effective treatment for local control

Jose Luis Lopez et al. Rep Pract Oncol Radiother. .

Abstract

Background: Radiotherapy (RT) plays an important role in the multidisciplinary management of Ewing's Sarcoma (ES), especially in unresectable cases.

Aim: Assessment of efficacy of RT in terms of local control in pediatric patients with primary ES of bone.

Materials and methods: Thirty-six patients younger than 17 years old with ES treated with combined RT and chemotherapy with (N = 14) or without (N = 22) prior surgery from 1981 to 2008 were retrospectively reviewed. Since 1995, they were all treated according to the Spanish Society of Pediatric Oncology protocol (55.5% cases). Those patients received vincristine, ifosfamide, doxorubicin and etoposide. The TNM classification was as follows: 17 T1, 18 T2 and 1 T3; 36 N0; 29 M0, 5 M1a and 2 M1b. Analysis was stratified by treatment: definitive RT or pre/postoperative RT.

Results: The 36 patients (21 male; 15 female) had a median age of 10 years (range 2-17 years). Median follow-up of living patients was 105 months. The 2-year local control (LC) rate for all patients was 88%. Five-year LC rates for patients treated with definitive and pre/postoperative RT were 91% and 86%, respectively. Two-year overall survival and disease-free survival rates for all patients were 68% and 66%, respectively. Low phosphatase alkaline levels and local and distant recurrences were significantly predictive of worse prognosis (P = 0.021, P = 0.011, P = 0.007, respectively).

Conclusion: Radiotherapy with and without surgery is a highly effective local treatment option in the multidisciplinary management of ES in pediatric patients.

Keywords: Ewing's Sarcoma; Local control; Radiotherapy.

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Figures

Fig. 1
Fig. 1
Five-year local control. Solid line, definitive radiotherapy, N = 22; dotted line, pre/postoperative radiotherapy, N = 14.
Fig. 2
Fig. 2
Five-year overall survival. Solid line, definitive radiotherapy, N = 22; dotted line, pre/postoperative radiotherapy, N = 14.
See this image and copyright information in PMC

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