Casey Dana L, Meyers Paul A, Alektiar Kaled M, Magnan Heather, Healey John H, Boland Patrick J, Wolden Suzanne L
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, USA.
Radiother Oncol. 2014 Nov;113(2):248-53. doi: 10.1016/j.radonc.2014.11.023. Epub 2014 Nov 26.
To evaluate local control and survival outcomes in adults with Ewing sarcoma (ES) treated with radiotherapy (RT).
Retrospective review of all 109 patients age ⩾18 treated for ES with RT to the primary site at Memorial Sloan Kettering Cancer Center between 1990 and 2011. RT was used as the definitive local control modality in 44% of patients, preoperatively for 6%, and postoperatively for 50%.
Median age at diagnosis was 27years (range, 18-67). The 5-year local failure (LF) was 18%. Differences in LF were not identified when evaluated by modality of local control (RT versus combined surgery and RT), RT dose, fractionation, and RT technique. However, margin status at time of resection significantly predicted LF. The 5-year event-free survival and overall survival rates were 44% and 66% for patients with localized disease, compared with 16% and 26% for metastatic disease (p=0.0005 and 0.0002). Tumor size, histopathologic response to chemotherapy, and treatment on or according to a protocol were also significantly associated with survival.
This series of adults treated with modern chemotherapy and RT had prognostic factors and outcomes similar to adolescents with ES. All adults with ES should be treated with an aggressive, multidisciplinary approach.
评估接受放射治疗（RT）的成年尤因肉瘤（ES）患者的局部控制和生存结果。
回顾性分析1990年至2011年间在纪念斯隆凯特琳癌症中心接受原发部位RT治疗的所有109例年龄≥18岁的ES患者。44%的患者将RT用作确定性局部控制方式，6%的患者在术前使用，50%的患者在术后使用。
诊断时的中位年龄为27岁（范围18 - 67岁）。5年局部失败率（LF）为18%。按局部控制方式（RT与手术联合RT）、RT剂量、分割方式和RT技术评估时，未发现LF存在差异。然而，切除时的切缘状态显著预测LF。局限性疾病患者的5年无事件生存率和总生存率分别为44%和66%，而转移性疾病患者分别为16%和26%（p = 0.0005和0.0002）。肿瘤大小、对化疗的组织病理学反应以及是否按照方案进行治疗也与生存显著相关。
这组接受现代化疗和RT治疗的成年患者的预后因素和结果与青少年ES患者相似。所有成年ES患者均应采用积极的多学科方法进行治疗。
