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Autor
Andreou, Dimosthenis 1 Bhadri, Vivek 1 Brichard, Benedicte 1 Collaud, Stephane 1 Cyprová, Soňa 1 Dirksen, Uta 1 Eich, Hans 1 Ek, Torben 1 Gelderblom, Hans 1 Hardes, Jendrik 1 Hartmann, Wolfgang 1 Hauser, Peter 1 Haveman, Lianne 1 Heesen, Philip 1 Jabar, Susanne 1 Juergens, Heribert 1 Kanerva, Jukka 1 Kersting, Josephine 1 Kühne, Thomas 1 Raciborska, Anna 1
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Center for Pediatric Oncology and Hem... 1 Charles University Motol Children's H... 1 Childhood Cancer Center Queen Silvia ... 1 Chris O ́ Brien Lifehouse Camperdown ... 1 Clinic for Particle Therapy West Germ... 1 Clinic of Orthopedics University Hosp... 1 Department of Medical Oncology Leiden... 1 Department of Oncology Haematology Un... 1 Department of Orthopedics and Trauma ... 1 Department of Pediatric Haematology a... 1 Department of Pediatric Hematology an... 1 Department of Solid Tumors Princess M... 1 Department of Thoracic Surgery Ruhrla... 1 Gerhard Domagk Institute for Patholog... 1 German Cancer Consortium Partnersite ... 1 HUS Helsinki University Hospital New ... 1 Health University of Sydney Camperdow... 1 Mother and Child Institute Department... 1 Patient Representative St Josefs Hosp... 1 Pediatrics 3 West German Cancer Cente... 1
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Autor
Andreou, Dimosthenis 1 Bhadri, Vivek 1 Brichard, Benedicte 1 Collaud, Stephane 1 Cyprová, Soňa 1 Dirksen, Uta 1 Eich, Hans 1 Ek, Torben 1 Gelderblom, Hans 1 Hardes, Jendrik 1 Hartmann, Wolfgang 1 Hauser, Peter 1 Haveman, Lianne 1 Heesen, Philip 1 Jabar, Susanne 1 Juergens, Heribert 1 Kanerva, Jukka 1 Kersting, Josephine 1 Kühne, Thomas 1 Raciborska, Anna 1
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Pracoviště
Center for Pediatric Oncology and Hem... 1 Charles University Motol Children's H... 1 Childhood Cancer Center Queen Silvia ... 1 Chris O ́ Brien Lifehouse Camperdown ... 1 Clinic for Particle Therapy West Germ... 1 Clinic of Orthopedics University Hosp... 1 Department of Medical Oncology Leiden... 1 Department of Oncology Haematology Un... 1 Department of Orthopedics and Trauma ... 1 Department of Pediatric Haematology a... 1 Department of Pediatric Hematology an... 1 Department of Solid Tumors Princess M... 1 Department of Thoracic Surgery Ruhrla... 1 Gerhard Domagk Institute for Patholog... 1 German Cancer Consortium Partnersite ... 1 HUS Helsinki University Hospital New ... 1 Health University of Sydney Camperdow... 1 Mother and Child Institute Department... 1 Patient Representative St Josefs Hosp... 1 Pediatrics 3 West German Cancer Cente... 1
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BACKGROUND: Local treatment is a crucial element in the standard of care for Ewing sarcoma (EWS). While systemic treatment is improved in randomised clinical trials, local treatment modalities are discussed controversially. We analysed the association between local therapy and event-free survival (EFS), overall survival (OS), and local recurrence (LR) in prospectively collected data of patients with localised EWS. PATIENTS AND METHODS: We analysed data from the international Ewing 2008 study registered between 2009 and 2019 in 117 centres. After induction chemotherapy, patients received surgery, radiotherapy, or a combination thereof. We performed Cox regression, conducted propensity score-weighted sensitivity analysis, and performed subgroup analyses. Hazard ratios (HRs) and 95% confidence intervals are reported. RESULTS: We included 863 patients with localised EWS (surgery alone: 331, combination therapy: 358, definitive radiotherapy: 174). In patients treated with combination therapy compared to surgery alone, EFS HR was 0.84 (0.57-1.24; p = 0.38), OS HR was 0.84 (0.57-1.23; p = 0.41), and LR HR was 0.58 (0.26-1.31; p = 0.19). Hazards of any event were increased in patients treated with definitive radiotherapy compared to surgery only, HR 1.53 (1.02-2.31; p = 0.04). Patients with poor responses to chemotherapy benefitted from combination therapy over definitive surgery with an EFS HR 0.49 (0.27-0.89; p = 0.02). Patients with pelvic tumours benefitted from combination therapy over surgery only regarding LR, HR 0.12 (0.02-0.72; p = 0.02). CONCLUSION: Patients with poor responses to chemotherapy benefitted from radiotherapy added to surgery. In the whole group, radiotherapy alone as opposed to surgery alone increased the hazards of any event.
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- doba přežití bez progrese choroby MeSH
- Ewingův sarkom * terapie MeSH
- indukční chemoterapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- radiační onkologie * MeSH
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