期刊
ANNALS OF ONCOLOGY
卷 19, 期 4, 页码 814-820出版社
ELSEVIER
DOI: 10.1093/annonc/mdm521
关键词
distant recurrence; Ewing sarcoma; local recurrence; pediatric cancer
类别
资金
- NCI NIH HHS [CA 21765, P30 CA23099] Funding Source: Medline
Background: Advances in the treatment of Ewing sarcoma family of tumors (ESFT) are the result of improvements in systemic and local therapies. The individual contributions of each treatment component cannot be analyzed separately; improvements in local and systemic control can influence each other. Patients and methods: We reviewed the records of 220 patients treated on institutional protocols from 1979 to 2004. Factors predictive of local and distant recurrence were analyzed. Results: The median age at diagnosis was 13.7 years. Ninety- five patients relapsed at a median of 1.6 years. The 5- year overall survival estimate was 63.5% +/- 6 3.5%. The estimated 5- year cumulative incidence (CI) of local failure was 25.1% +/- 6 3.0%. Local failure was associated with treatment era (P < 0.001), tumor size (P = 0.037) and type of local control (P = 0.021). Systemic treatment intensification improved local control. The estimated 5- year CI of distant recurrence was 22.5% +/- 6 2.9%. Patients with localized disease (P < 0.001), smaller tumors (P = 0.018) and those who received surgery 6 radiation for local control (P = 0.023) had lower CI of distant failure. Conclusions: Successful treatment of ESFT requires optimal systemic and local therapy. Both treatment modalities are intertwined and the control of both local and distant disease is the result of the combined approach.
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