What is the impact of local control in Ewing sarcoma: analysis of the first Brazilian collaborative study group – EWING1

BMC Cancer - Tập 17 - Trang 1-9 - 2017
Ricardo G. Becker1, Lauro J. Gregianin2,3, Carlos R. Galia4, Reynaldo Jesus-Garcia Filho5, Eduardo A. Toller6, Gerardo Badell7, Suely A. Nakagawa8, Alexandre David9, André M. Baptista10, Eduardo S. Yonamime11, Osvaldo A. Serafini12, Valter Penna13, Julie Francine C. Santos14, Algemir L. Brunetto14
1Service of Orthopedics and Traumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
2Department of Pediatrics, HCPA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
3Department of Pediatrics, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
4Service of Orthopedics and Traumatology, HCPA, Porto Alegre, Brazil
5Support Group for Children and Adolescents with Cancer (GRAACC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
6Fundação Pio XII, Hospital de Câncer Infantojuvenil, Barretos, Brazil
7Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
8Orthopedics Service, Hospital A.C. Camargo Cancer Center, São Paulo, Brazil
9Service of Orthopedics and Traumatology, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
10Orthopedic Trauma Institute, Hospital das Clínicas de São Paulo, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
11Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (HSCSP), São Paulo, Brazil
12Service of Orthopedics and Traumatology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
13Hospital das Clínicas de Botucatu, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
14Instituto do Câncer Infantil, Porto Alegre, Brazil

Tóm tắt

Relapse in localized Ewing sarcoma patients has been a matter of concern regarding poor prognosis. Therefore, we investigated the impact of local control modality (surgery, surgery plus radiotherapy, and radiotherapy) on clinical outcomes such as survival and recurrence in patients with non-metastatic Ewing sarcoma treated on the first Brazilian Collaborative Group Trial of the Ewing Family of Tumors (EWING1). Seventy-three patients with localized Ewing sarcoma of bone aged < 30 years were included. The treating physicians defined the modality of local control based on the recommendations of the coordinating center and the patient and tumor characteristics. Possible associations of local control modality with local failure (LF), disease-free survival (DFS), event-free survival (EFS), overall survival (OS), and clinical characteristics were analyzed. Mean patient age was 12.8 years (range, 2 to 25 years) and median follow-up time was 4.5 years (range, 2.3 to 6.7 years). Forty-seven patients underwent surgery, 13 received radiotherapy, and 13 received both. The 5-year EFS, OS, and DFS for all patients was 62.1%, 63.3%, and 73.1%, respectively. The 5-year cumulative incidence (CI) of LF was 7.6% for surgery, 11.1% for radiotherapy, and 0% for postoperative radiotherapy (PORT) (p = 0.61). The 5-year EFS was 71.7% for surgery, 30.8% for radiotherapy, and 64.1% for PORT (p = 0.009). There was a significant effect of local control modality on EFS and OS in the study. Surgery and PORT modalities yielded very close results. The group treated with radiotherapy alone had considerably worse outcomes. This may be confounded by greater risk factors in these patients. There was no significant effect of local control modality on the CI of LF and DFS.

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