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Role of Radiotherapy in the Multimodal Treatment of Ewing Sarcoma Family Tumors

Authors
 Yunseon Choi  ;  Do Hoon Lim  ;  Soo Hyun Lee  ;  Chuhl Joo Lyu  ;  Jung Ho Im  ;  Yun-Han Lee  ;  Chang-Ok Suh 
Citation
 Cancer Research and Treatment, Vol.47(4) : 904-912, 2015 
Journal Title
 Cancer Research and Treatment 
ISSN
 1598-2998 
Issue Date
2015
MeSH
Adolescent ; Adult ; Antineoplastic Agents/therapeutic use* ; Bone Neoplasms/drug therapy* ; Bone Neoplasms/radiotherapy* ; Child ; Child, Preschool ; Combined Modality Therapy/methods* ; Female ; Humans ; Infant ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Retrospective Studies ; Sarcoma, Ewing/drug therapy* ; Sarcoma, Ewing/radiotherapy* ; Treatment Outcome ; Young Adult
Keywords
Ewing sarcoma ; Radiotherapy ; Surgery ; Tumor burden
Abstract
PURPOSE: The aim of this study was to evaluate the role of radiotherapy (RT) in the management of Ewing sarcoma family tumors (ESFT). MATERIALS AND METHODS: Retrospective analysiswas performed on 91 patientswith localized ESFT treated from 1988 to 2012. Primary tumor size was ≥ 8 cm in 33 patients. Surgery, RT, and combined surgery with RT were applied in 37, 15, and 33 patients, respectively. RESULTS: Median follow-up was 43.8 months. Forty-three patients (47.3%) showed recurrence or progressive disease. Twelve patients (13.2%) showed local failure after initial treatment. Thirty-nine patients (42.9%) experienced distant metastases. The 5-year overall survival (OS), progression-free survival, and local control (LC) were 60.5%, 58.2%, and 85.1%, respectively. According to treatment, 5-year LCwas 64.8% with RT and 90.2% with combined surgery and RT (p=0.052). Prognostic factors for OS were tumor size (≥ 8 cm, p < 0.001) and surgical resection (p < 0.001). In large tumors (≥ 8 cm), combined surgery and RT produced better LC compared to RT (p=0.033). However, in smaller tumors (< 8 cm), RT without surgery resulted in a similar LC rate as RT with surgery (p=0.374). CONCLUSION: RT used for patients with unfavorable risk factors resulted in worse outcome than for patientswho received surgery. Smallertumors could be controlled locallywith chemotherapy and RT. For large tumors, combined surgery and RT is needed. Proper selection of local treatment modality, RT, surgery, or both is crucial in the management of ESFT.
Files in This Item:
T201505783.pdf Download
DOI
10.4143/crt.2014.158
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
서창옥(Suh, Chang Ok)
유철주(Lyu, Chuhl Joo) ORCID logo https://orcid.org/0000-0001-7124-7818
이수현(Lee, Soo Hyeon)
이윤한(Lee, Yun Han)
임정호(Im, Jung Ho)
최윤선(Choi, Yun Seon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157173
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