Journal Article

What is the impact of local control in Ewing sarcoma: analysis of the first Brazilian collaborative study group – EWING1

Serafini, Osvaldo A., Santos, Julie Francine C., David, Alexandre, Brunetto, Algemir L., Yonamime, Eduardo S., Baptista, André M., Nakagawa, Suely A., Gregianin, Lauro J., Penna, Valter, Galia, Carlos R., Toller, Eduardo A., Becker, Ricardo G., Badell, Gerardo, Jesus-Garcia Filho, Reynaldo

2017

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Biomedical and Life Sciences / Biomedicine / Bone cancer / Bone Neoplasms - mortality / Bone Neoplasms - pathology / Bone Neoplasms - therapy / Bone tumors / Brazil / cancer imaging / Cancer Research / Cancer therapies / Care and treatment / Chemotherapy / Child / Child, Preschool / Collaboration / Combined Modality Therapy / Diseases / Ewing sarcoma / Ewing's sarcoma / Ewings sarcoma / Female / Gangrene / Health aspects / Health Promotion and Disease Prevention / Humans / Influence / interventional therapeutics / Local control / Magnetic Resonance Imaging - methods / Male / Medical prognosis / Medicine/Public Health / Metastases / Neoplasm Metastasis / Neoplasm Staging / NMR / Nuclear magnetic resonance / Oncology / Orthopedics / Patients / Pediatrics / Prognosis / Proportional Hazards Models / Radiation oncology / Radiation therapy / Radiotherapy / Relapse / Research Article / Risk factors / Sarcoma, Ewing - mortality / Sarcoma, Ewing - pathology / Sarcoma, Ewing - therapy / Studies / Surgery / Surgical Oncology / Survival / Tomography, X-Ray Computed / Treatment Outcome / Tumor Burden / Tumors / Young Adult