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BMC Cancer. 2017 Jun 15;17(1):420. doi: 10.1186/s12885-017-3391-5.

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

Author information

1
Service of Orthopedics and Traumatology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Bairro Santa Cecilia, Porto Alegre, RS, 90035-903, Brazil. rbecker@hcpa.edu.br.
2
Department of Pediatrics, HCPA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
3
Department of Pediatrics, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
4
Service of Orthopedics and Traumatology, HCPA, Porto Alegre, RS, Brazil.
5
Support Group for Children and Adolescents with Cancer (GRAACC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
6
Fundação Pio XII, Hospital de Câncer Infantojuvenil, Barretos, SP, Brazil.
7
Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
8
Orthopedics Service, Hospital A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
9
Service of Orthopedics and Traumatology, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
10
Orthopedic Trauma Institute, Hospital das Clínicas de São Paulo, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
11
Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (HSCSP), São Paulo, SP, Brazil.
12
Service of Orthopedics and Traumatology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
13
Hospital das Clínicas de Botucatu, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
14
Instituto do Câncer Infantil, Porto Alegre, RS, Brazil.

Abstract

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.

KEYWORDS:

Bone tumors; Ewing sarcoma; Local control; Orthopedics; Radiation oncology; Surgery

PMID:
28619077
PMCID:
PMC5472913
DOI:
10.1186/s12885-017-3391-5
[Indexed for MEDLINE]
Free PMC Article

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