Impact of Local Management on Long-Term Outcomes in Ewing Tumors of the Pelvis and Sacral Bones: The University of Florida Experience

Spinal and Paraspinal Ewing Tumors

“…Given the long interval between local RT and total body irradiation (TBI), the TBI course was not considered in the Gy 10 calculations, which primarily reflected acute effects. This method is consistent with our previous analyses (16,17,19). Using this premise, the median BED for the patients treated with definitive RT was 61.8 Gy 10 (range, 48.4-78.6).…”

“…of irreversible normal tissue toxicity can alter the dose and/or size of the radiation field, producing marginal radiation misses (13) and perhaps accounting for the inferior LC rates compared with Ewing tumors of the extremities (3). Nonetheless, in nonmetastatic patients treated with definitive RT at our institution, we observed a LC rate of 89% for PETS compared with 72% for Ewing tumor in the extremities and 67% in the pelvis (15)(16)(17). Because of the early neurologic symptoms, most of the PETS in our series were identified before they grew to be >8 cm.…”

“…The most common symptom at presentation was local or radicular pain (85%); 66% of all patients had a neurologic complaint at presentation. The median interval between the onset of symptoms and diagnosis was 2.3 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], and the median volume was 205 cm 3 (range, 12-1,256). For the whole group, the 5-year actuarial OS, CSS, EFS, and LC rate was 62%, 62%, 47%, and 90%, respectively.…”

“…Earlier reports from the University of Florida have documented our evolving indications for the general role of RT in Ewing tumors (15)(16)(17). Our goal in local management has traditionally been to use surgery or RT alone, reserving combined therapy (surgery plus RT) for patients at high risk of local failure.…”

Chest Wall Ewing Sarcoma Family of Tumors: Long-Term Outcomes

“…This retrospective series reveals a 79% LC rate in patients with nonmetastatic disease; intensive treatment resulted in infrequent but serious morbidity. With a 5-year CSS rate of only 44% for nonmetastatic disease and 34% for metastatic disease, the prognosis of these patients is poor compared with Ewing series addressing other sites, both from our institution and elsewhere (5,(11)(12)(13)(14)(15)(16)(17)(18).…”