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Int J Radiat Oncol Biol Phys. 2015 Aug 1;92(5):1069-76. doi: 10.1016/j.ijrobp.2015.04.048. Epub 2015 May 2.

Intraoperative Electron-Beam Radiation Therapy for Pediatric Ewing Sarcomas and Rhabdomyosarcomas: Long-Term Outcomes.

Author information

1
Department of Radiation Oncology, Instituto de Radiomedicina, Santiago, Chile; School of Medicine, Complutense University, Madrid, Spain. Electronic address: csole@iram.cl.
2
School of Medicine, Complutense University, Madrid, Spain; Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
3
Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
4
Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona, Spain.
5
School of Medicine, Complutense University, Madrid, Spain; Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
6
School of Medicine, Complutense University, Madrid, Spain; Department of Experimental Surgery and Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Abstract

PURPOSE:

To assess long-term outcomes and toxicity of intraoperative electron-beam radiation therapy (IOERT) in the management of pediatric patients with Ewing sarcomas (EWS) and rhabdomyosarcomas (RMS).

METHODS AND MATERIALS:

Seventy-one sarcoma (EWS n=37, 52%; RMS n=34, 48%) patients underwent IOERT for primary (n=46, 65%) or locally recurrent sarcomas (n=25, 35%) from May 1983 to November 2012. Local control (LC), overall survival (OS), and disease-free survival were estimated using Kaplan-Meier methods. For survival outcomes, potential associations were assessed in univariate and multivariate analyses using the Cox proportional hazards model.

RESULTS:

After a median follow-up of 72 months (range, 4-310 months), 10-year LC, disease-free survival, and OS was 74%, 57%, and 68%, respectively. In multivariate analysis after adjustment for other covariates, disease status (P=.04 and P=.05) and R1 margin status (P<.01 and P=.04) remained significantly associated with LC and OS. Nine patients (13%) reported severe chronic toxicity events (all grade 3).

CONCLUSIONS:

A multimodal IOERT-containing approach is a well-tolerated component of treatment for pediatric EWS and RMS patients, allowing reduction or substitution of external beam radiation exposure while maintaining high local control rates.

PMID:
26194682
DOI:
10.1016/j.ijrobp.2015.04.048
[Indexed for MEDLINE]
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