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Multicenter Study
. 2021 Feb 10;10(2):366.
doi: 10.3390/cells10020366.

Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis

Mateusz Jacek Spałek  1 , Jan Poleszczuk  2   3 , Anna Małgorzata Czarnecka  1   4 , Monika Dudzisz-Śledź  1 , Aleksandra Napieralska  5 , Jacek Matysiakiewicz  6 , Marzanna Chojnacka  7 , Anna Raciborska  8 , Aleksandra Sztuder  9 , Adam Maciejczyk  9   10 , Agata Szulc  9 , Tomasz Skóra  11 , Bożena Cybulska-Stopa  12 , Tomasz Winiecki  13 , Joanna Kaźmierska  13   14 , Bartłomiej Tomasik  15   16   17 , Jacek Fijuth  15 , Piotr Rutkowski  1
Affiliations
Multicenter Study

Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis

Mateusz Jacek Spałek et al. Cells. .

Abstract

Background: Due to the rarity of osteosarcoma and limited indications for radiotherapy (RT), data on RT for this tumor are scarce. This study aimed to investigate the utilization of RT for osteosarcomas in the recent 20 years and to identify factors related to patients' response to radiation.

Methods: We performed a retrospective analysis of patients irradiated for osteosarcoma treatment. We planned to assess differences in the utilization of RT between the periods of 2000-2010 and 2011-2020, identify the risk factors associated with local progression (LP), determine whether RT-related parameters are associated with LP, and calculate patients' survival.

Results: A total of 126 patients with osteosarcoma who received 181 RT treatments were identified. We found a difference in RT techniques between RT performed in the years 2000-2010 and that performed in the years 2011-2020. LP was observed after 37 (20.4%) RT treatments. Intent of RT, distant metastases, and concomitant systemic treatment affected the risk of LP. Five-year overall survival was 33% (95% confidence interval (26%-43%)).

Conclusions: RT for osteosarcoma treatment has evolved from simple two-dimensional palliative irradiation into more conformal RT applied for new indications including oligometastatic and oligoprogressive disease. RT may be a valuable treatment modality for selected patients with osteosarcoma.

Keywords: bone cancer; image-guided; intensity-modulated; osteosarcoma; radiotherapy; sarcoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Hazard ratios for local progression with 95% confidence intervals and p-values calculated from a multivariate and a univariate Cox proportional hazards model.
Figure 2
Figure 2
Hazard ratios for local progression or death with 95% confidence intervals and p-values calculated from a multivariate and univariate Cox proportional hazards model.
Figure 3
Figure 3
Overall survival curves for (a) all analyzed patients; all analyzed patients divided into subgroups based on (b) age, (c) intent of radiotherapy, and (d) performance status.
See this image and copyright information in PMC

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