Salah Samer, Halalsheh Hadeel, Abuhijla Fawzi, Ismael Taleb, Yaser Sameer, Shehadeh Ahmad, Abdelal Samer, Sultan Iyad, Almousa Abdelatif, Abu Hijlih Ramiz
Medical Oncology Department, King Hussein Cancer Center, Queen Rania Al-Abdullah Street 202, Amman-Jordan.
Pediatric Oncology Department, King Hussein Cancer Center, Queen Rania Al-Abdullah Street 202, Amman-Jordan.
Rep Pract Oncol Radiother. 2020 Mar-Apr;25(2):255-259. doi: 10.1016/j.rpor.2020.02.001. Epub 2020 Feb 21.
To assess the impact of delay in local control on survival outcomes of Ewing sarcoma (ES) patients.
The cornerstone of therapy of localized ES includes chemotherapy and local control with surgery or radiotherapy. We sought to assess the impact of delay (>15 weeks) in timing of local control on survival outcomes of ES patients.
Data of consecutive patients with primary non-metastatic ES of the extremities, treated at a single institution were collected. The impact of delay of timing for local control, demographics, and disease characteristics on overall survival (OS) was analyzed.
A total of 43 patients with ES of the extremity were included. All patients received neoadjuvant chemotherapy. Local control was by surgery in 36 patients and definitive radiation in 7. A total of 16 patients had delay in local control. At a median follow of up of 48 months, patients with delay in local control had significantly inferior OS compared to those with optimal local control timing (5-year OS 56% vs. 80%, respectively, = 0.044). Other factors that predicted inferior OS included definitive radiation as opposed to definitive surgery (5-year OS 25% vs. 79%, respectively, = 0.041) and tumor necrosis <90% as opposed to ≥90% (5-year OS 55% vs. 90%, respectively, = 0.01).
Delay in definitive therapy, local control with radiation as opposed to surgery and poor post-chemotherapy tumor necrosis predict inferior OS in ES. Adopting strategies to minimize delay in local control could improve survival outcomes.
评估局部控制延迟对尤因肉瘤（ES）患者生存结局的影响。
局限性ES治疗的基石包括化疗以及手术或放疗进行局部控制。我们试图评估局部控制时机延迟（>15周）对ES患者生存结局的影响。
收集在单一机构接受治疗的连续性原发性非转移性肢体ES患者的数据。分析局部控制时机延迟、人口统计学特征和疾病特征对总生存期（OS）的影响。
共纳入43例肢体ES患者。所有患者均接受了新辅助化疗。36例患者通过手术进行局部控制，7例通过根治性放疗。共有16例患者局部控制延迟。在中位随访48个月时，局部控制延迟的患者的OS明显低于局部控制时机最佳的患者（5年总生存率分别为56%和80%，P = 0.044）。其他预测较差OS的因素包括采用根治性放疗而非根治性手术（5年总生存率分别为25%和79%，P = 0.041）以及化疗后肿瘤坏死<90%而非≥90%（5年总生存率分别为55%和90%，P = 0.01）。
确定性治疗延迟、采用放疗而非手术进行局部控制以及化疗后肿瘤坏死较差预示着ES患者的OS较差。采取策略尽量减少局部控制的延迟可改善生存结局。
