Lopez Jose Luis, Cabrera Patricia, Ordoñez Rafael, Marquez Catalina, Ramirez Gema Lucia, Praena-Fernandez Juan Manuel, Ortiz Maria Jose
Virgen del Rocío University Hospital, Department of Radiation Oncology, Seville, Spain.
Virgen del Rocío University Hospital, Department of Pediatric Oncology, Seville, Spain.
Rep Pract Oncol Radiother. 2011 Mar 12;16(3):103-9. doi: 10.1016/j.rpor.2011.01.006. eCollection 2011.
Radiotherapy (RT) plays an important role in the multidisciplinary management of Ewing's Sarcoma (ES), especially in unresectable cases.
Assessment of efficacy of RT in terms of local control in pediatric patients with primary ES of bone.
Thirty-six patients younger than 17 years old with ES treated with combined RT and chemotherapy with (N = 14) or without (N = 22) prior surgery from 1981 to 2008 were retrospectively reviewed. Since 1995, they were all treated according to the Spanish Society of Pediatric Oncology protocol (55.5% cases). Those patients received vincristine, ifosfamide, doxorubicin and etoposide. The TNM classification was as follows: 17 T1, 18 T2 and 1 T3; 36 N0; 29 M0, 5 M1a and 2 M1b. Analysis was stratified by treatment: definitive RT or pre/postoperative RT.
The 36 patients (21 male; 15 female) had a median age of 10 years (range 2-17 years). Median follow-up of living patients was 105 months. The 2-year local control (LC) rate for all patients was 88%. Five-year LC rates for patients treated with definitive and pre/postoperative RT were 91% and 86%, respectively. Two-year overall survival and disease-free survival rates for all patients were 68% and 66%, respectively. Low phosphatase alkaline levels and local and distant recurrences were significantly predictive of worse prognosis (P = 0.021, P = 0.011, P = 0.007, respectively).
Radiotherapy with and without surgery is a highly effective local treatment option in the multidisciplinary management of ES in pediatric patients.
放射治疗（RT）在尤因肉瘤（ES）的多学科治疗中发挥着重要作用，尤其是在不可切除的病例中。
评估放射治疗对原发性骨ES儿科患者局部控制方面的疗效。
回顾性分析了1981年至2008年间36例17岁以下接受放疗联合化疗的ES患者，其中14例在放疗前接受过手术，22例未接受过手术。自1995年起，所有患者均按照西班牙儿科肿瘤学会方案进行治疗（55.5%的病例）。这些患者接受了长春新碱、异环磷酰胺、阿霉素和依托泊苷治疗。TNM分类如下：17例T1，18例T2，1例T3；36例N0；29例M0，5例M1a和2例M1b。分析按治疗方式分层：根治性放疗或术前/术后放疗。
36例患者（21例男性，15例女性）的中位年龄为10岁（范围2 - 17岁）。存活患者的中位随访时间为105个月。所有患者的2年局部控制（LC）率为88%。接受根治性放疗和术前/术后放疗患者的5年LC率分别为91%和86%。所有患者的2年总生存率和无病生存率分别为68%和66%。低碱性磷酸酶水平以及局部和远处复发显著预示预后较差（分别为P = 0.021、P = 0.011、P = 0.007）。
无论是否进行手术，放射治疗都是儿科患者ES多学科治疗中一种高效的局部治疗选择。
