EWING'S SARCOMA: LOCAL TUMOR CONTROL AND PATTERNS OF FAILURE FOLLOWING LIMITED-VOLUME RADIATION THERAPY

摘要: Sixty children with localized osseous Ewing's sarcoma were treated between 1978 and 1988 induction chemotherapy (cyclophosphamide, adriamycin), irradiation and/or surgery, 10 months of maintenance adriamycin, dactinomycin, vincristine). Following chemotherapy, 43 patients received primary radiation therapy to limited volumes defined by post-chemotherapy residual soft tissue tumor extension initial extent. Irradiation was as low dose at 30–36 Gy (median 35 Gy) for 31 cases objective response high 50–60 50.4 12 poor or tumors ≥8 cm. Overall event-free survival 5 years is 59% local control 68%. Initial failures have been (12), simultaneous distant (7), (6). In the surgical resection group, 14 had complete without therapy, 3 microscopic plus 35–41 Gy; 100% has maintained. 58% (p = .004). Despite volume, 18/19 occurred centrally within bone, well volume. Imaging predicted in group: 62% response/partial versus 17% no response/progressive disease < 0.01). Local related strongly size group; among receiving Gy, 90% lesions <8 cm 52% .054). The central pattern failure this experience suggests effectiveness overall rate following tested level appears be inadequate, although results selected 〈8 greatest dimension indicate potential efficacy a yet experience.