a Department of Orthopaedic Surgery, Xiamen branch , Zhongshan Hospital, Fudan University , Xiamen , China.
b Department of Radiation Oncology , Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China.
Expert Rev Anticancer Ther. 2018 May;18(5):501-506. doi: 10.1080/14737140.2018.1453360. Epub 2018 Mar 21.
To investigate the optimal local treatment strategies for patients with non-metastatic Ewing sarcoma (ES) of bone.
Patients with ES of bone were identified using the Surveillance Epidemiology and End Results database. Kaplan-Meier log-rank test and Cox regression models were performed to assess the effect of the types of local treatment strategies on cause-specific survival and overall survival.
560 patients were included with a median age of 16 years. A total of 284, 162 and 114 patients received surgery alone, surgery and radiotherapy, and radiotherapy alone, respectively. The types of local treatment strategies had no effect on survival outcomes in multivariate analysis. In the subgroup analysis of patients with tumor diameter <8 cm, surgery ± radiotherapy had a significantly improved cause-specific survival (P = 0.039), and had potential to improve overall survival (P = 0.070) in multivariate analysis. The local treatment strategies had no effect on survival in patients with different tumor location.
There is no local treatment of choice for non-metastatic ES of bone in terms of survival. More well-designed studies are needed to confirm our findings and investigate the role of various local treatment strategies in relation to primary tumor diameter.
为了研究非转移性骨尤文肉瘤(ES)患者的最佳局部治疗策略。
使用监测、流行病学和最终结果数据库来确定骨 ES 患者。使用 Kaplan-Meier 对数秩检验和 Cox 回归模型来评估局部治疗策略的类型对特定原因生存率和总生存率的影响。
共纳入 560 例患者,中位年龄为 16 岁。分别有 284、162 和 114 例患者接受了单纯手术、手术加放疗和单纯放疗。多变量分析表明,局部治疗策略的类型对生存结果没有影响。在肿瘤直径<8cm 的患者亚组分析中,手术±放疗在多变量分析中显著提高了特定原因生存率(P=0.039),并有可能改善总生存率(P=0.070)。局部治疗策略对不同肿瘤部位的患者的生存没有影响。
就生存而言,非转移性骨 ES 没有首选的局部治疗方法。需要更多精心设计的研究来证实我们的发现,并研究各种局部治疗策略与原发肿瘤直径的关系。