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Ewing sarcoma in adults treated with modern radiotherapy techniques
Dana L Casey1, Paul A Meyers2, Kaled M Alektiar1
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
Summary
Adults with Ewing sarcoma (ES) treated with radiotherapy (RT) showed similar outcomes to adolescents. Achieving negative surgical margins is crucial for local control in ES patients. Aggressive, multidisciplinary treatment is recommended for adult ES.
Area of Science:
- Oncology
- Radiation Oncology
- Skeletal System Neoplasms
Background:
- Ewing sarcoma (ES) is a rare bone and soft tissue cancer.
- Treatment and outcomes in adults with ES are less understood than in adolescents.
- Radiotherapy (RT) is a key modality for local control in ES.
Purpose of the Study:
- To evaluate local control and survival outcomes in adult patients with ES.
- To identify prognostic factors influencing outcomes in adult ES.
- To compare outcomes of adult ES with those of adolescent ES.
Main Methods:
- Retrospective review of 109 adult patients with ES treated with RT.
- Analysis of RT as definitive, preoperative, or postoperative local control.
- Evaluation of local failure (LF) rates and survival based on treatment and disease characteristics.
Main Results:
- The 5-year local failure rate was 18%.
- Margin status at resection significantly predicted LF.
- Localized disease had significantly better 5-year event-free survival (44%) and overall survival (66%) than metastatic disease (16% and 26%).
- Tumor size, chemotherapy response, and protocol treatment impacted survival.
Conclusions:
- Adults with ES treated with modern chemotherapy and RT have prognostic factors and outcomes comparable to adolescents.
- Negative surgical margins are critical for improving local control.
- An aggressive, multidisciplinary treatment approach is recommended for all adult ES patients.
