Cancer Research and Treatment

Original Articles

Role of Radiotherapy in the Multimodal Treatment of Ewing Sarcoma Family Tumors: Yunseon Choi, Do Hoon Lim, Soo Hyun Lee, Chuhl Joo Lyu, Jung Ho Im, Yun-Han Lee, Chang-Ok Suh; Cancer Res Treat. 2015;47(4):904-912. Published online February 16, 2015; DOI: https://doi.org/10.4143/crt.2014.158

Purpose
The aim of this study was to evaluate the role of radiotherapy (RT) in the management of Ewing sarcoma family tumors (ESFT). Materials and Methods Retrospective analysiswas performed on 91 patientswith localized ESFT treated from 1988 to 2012. Primary tumor size was ≥ 8 cm in 33 patients. Surgery, RT, and combined surgery with RT were applied in 37, 15, and 33 patients, respectively.
Results
Median follow-up was 43.8 months. Forty-three patients (47.3%) showed recurrence or progressive disease. Twelve patients (13.2%) showed local failure after initial treatment. Thirty-nine patients (42.9%) experienced distant metastases. The 5-year overall survival (OS), progression-free survival, and local control (LC) were 60.5%, 58.2%, and 85.1%, respectively. According to treatment, 5-year LCwas 64.8% with RT and 90.2% with combined surgery and RT (p=0.052). Prognostic factors for OS were tumor size (≥ 8 cm, p < 0.001) and surgical resection (p < 0.001). In large tumors (≥ 8 cm), combined surgery and RT produced better LC compared to RT (p=0.033). However, in smaller tumors (< 8 cm), RT without surgery resulted in a similar LC rate as RT with surgery (p=0.374). Conclusion RT used for patients with unfavorable risk factors resulted in worse outcome than for patientswho received surgery. Smallertumors could be controlled locallywith chemotherapy and RT. For large tumors, combined surgery and RT is needed. Proper selection of local treatment modality, RT, surgery, or both is crucial in the management of ESFT.

Citations

Citations to this article as recorded by

Primary Ewing’s Sarcoma of Body of Mandible, Multimodal Treatment with Excellent Spontaneous Bone Regeneration: a Case Report
Rangila Ram, Priyanka Bhardwaj, Yogesh Bhardwaj, Narotam Ghezta, Ravi Bhatt, Pravesh Dhiman
Journal of Maxillofacial and Oral Surgery.2023; 22(3): 554. CrossRef
Ewing’s sarcoma masquerading as an odontogenic infection
Rizwan Hamid, Ambika Gaur, Sunita Gupta, Ritu Garg
Journal of Cancer Research and Therapeutics.2023; 19(Suppl 2): S950. CrossRef
18F‐FDG PET and PET/CT as a diagnostic method for Ewing sarcoma: A systematic review and meta‐analysis
Nimish Seth, Ishith Seth, Gabriella Bulloch, Adrian Hang Yue Siu, Allen Guo, Rukmini Chatterjee, Michael MacManus, Leo Donnan
Pediatric Blood & Cancer.2022;[Epub] CrossRef
Management of Unresectable Localized Pelvic Bone Sarcomas: Current Practice and Future Perspectives
Joaquim Soares do Brito, Miguel Esperança-Martins, André Abrunhosa-Branquinho, Cecilia Melo-Alvim, Raquel Lopes-Brás, João Janeiro, Dolores Lopez-Presa, Isabel Fernandes, José Portela, Luis Costa
Cancers.2022; 14(10): 2546. CrossRef
Radiation Therapy Dose Escalation in Unresectable Ewing Sarcoma: Final Results of a Phase 3 Randomized Controlled Trial
Siddhartha Laskar, Shwetabh Sinha, Abhishek Chatterjee, Nehal Khanna, Jifmi Jose Manjali, Ajay Puri, Ashish Gulia, Prakash Nayak, Tushar Vora, Girish Chinnaswamy, Maya Prasad, Jyoti Bajpai, Shashikant Juvekar, Subhash Desai, Amit Janu, Venkatesh Rangaraja
International Journal of Radiation Oncology*Biology*Physics.2022; 113(5): 996. CrossRef
Adjuvant Radiotherapy for the Multimodal Treatment of Pediatric Ewing Sarcoma
Gonca ALTINIŞIK İNAN, İpek Pınar ARAL, Tarık KARGIOĞLU, Arzu YAZAL ERDEM, Selma ÇAKMAKCI, Hüseyin Furkan ÖZTÜRK, Suheyla AYTAÇ ARSLAN, Yılmaz TEZCAN
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Pelvic Ewing sarcoma: Should all patients receive pre-operative radiotherapy, or should it be delivered selectively?
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The patterns of distant metastasis and prognostic factors in patients with primary metastatic Ewing sarcoma of the bone
Lei Zhang, Lu Xiong, Li-Mei Wu, Wen-Hui Shen, Ping Zhou, Chen-Lu Lian, Wen-Tong Zhang, San-Gang Wu
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Mohammadreza Bordbar, Ali Sarfaraz, Sezaneh Haghpanah, Omidreza Zekavat, Soheila Zareifar, Tahereh Zarei
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Reconstruction after Subtotal Sacrectomy for Sacral Ewing’s Sarcoma Using Tibial Allograft Strut Grafting: A Case Report
Ryosuke Hirota, Makoto Emori, Yoshinori Terashima, Kousuke Iba, Noriyuki Iesato, Ryunosuke Fukushi, Mitsunori Yoshimoto, Toshihiko Yamashita
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In Vitro and In Vivo Characterization of a Preclinical Irradiation-Adapted Model for Ewing Sarcoma
Mary Carroll Shapiro, Tien Tang, Atreyi Dasgupta, Lyazat Kurenbekova, Ryan Shuck, M. Waleed Gaber, Jason T. Yustein
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Comparison of the effects of local treatment strategies in non-metastatic Ewing sarcoma of bone
Wen-Tong Zhang, Wen-Wen Zhang, Zhen-Yu He, Jia-Yuan Sun, Lei Zhang, Qing Xia, San-Gang Wu
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Hemipelvectomías tras sarcomas de localización pélvica de alto grado: pronóstico en condrosarcomas frente a otros tipos histológicos
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The Role of Radiotherapy in Local Control of Nonextremity Ewing Sarcomas
Ozlem O. Akagunduz, Serra A. Kamer, Burcin Kececi, Bengu Demirag, Haldun Oniz, Mehmet Kantar, Nazan Cetingul, Dundar Sabah, Yavuz Anacak
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Ewing's sarcoma of bone tumor cells produces MCSF that stimulates monocyte proliferation in a novel mouse model of Ewing's sarcoma of bone
B.S. Margulies, S.D. DeBoyace, T.A. Damron, M.J. Allen
Bone.2015; 79: 121. CrossRef

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Clinical Outcome of Relapsed or Refractory Burkitt Lymphoma and Mature B-Cell Lymphoblastic Leukemia in Children and Adolescents: Hyery Kim, Eun Sil Park, Soo Hyun Lee, Hong Hoe Koo, Hyo Sun Kim, Chuhl Joo Lyu, So Eun Jun, Young Tak Lim, Hee Jo Baek, Hoon Kook, Ji Won Lee, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin, Hyeo Seop Ahn; Cancer Res Treat. 2014;46(4):358-365. Published online July 21, 2014; DOI: https://doi.org/10.4143/crt.2013.047

Abstract PDF PubReader ePub

Purpose
Despite the rapid improvement in survival rate from Burkitt lymphoma and mature B-cell lymphoblastic leukemia (B-ALL) in children, a small subset of patients do not respond to first-line chemotherapy or experience relapse (RL). Herein, we report the clinical characteristics and outcomes of these patients.
Materials and Methods
RL or refractory Burkitt lymphoma and mature B-ALL in 125 patients diagnosed from 1990 to 2009 were retrospectively analyzed.
Results
Nineteen patients experienced RL or progressive disease (PD). Among them, 12 patients had PD or RL less than six months after initial treatment and seven had late RL. Seven patients achieved complete response (CR), 11 had PD, and one had no more therapy. Six patients who achieved CR survived without evidence of disease and four of them underwent high-dose chemotherapy (HDC) followed by stem cell transplantation (SCT). However, 11 patients who failed to obtain CR eventually died of their disease. Five-year overall survival (OS) was 31.6±10.7%. OS of patients with late RL was superior to that of patients with early RL (57.1±18.7%, vs. 16.7±10.8%, p=0.014). Achievement of CR after reinduction had significant OS (p < 0.001). OS for patients who were transplanted was superior (p < 0.01). In multivariate analysis, achievement of CR after reinduction chemotherapy showed an association with improved OS (p=0.05).
Conclusion
Late RL and chemotherapy-sensitive patients have the chance to achieve continuous CR using HDC/SCT, whereas patients who are refractory to retrieval therapy have poor prognosis. Therefore, novel salvage strategy is required for improvement of survival for this small set of patients.

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Wernicke's Encephalopathy in Advanced Gastric Cancer: Eun Suk Jung, Obin Kwon, Soo Hyun Lee, Ki Byung Lee, Joo Hoon Kim, Sang Hyun Yoon, Gun Min Kim, Hei-Cheul Jeung, Sun Young Rha; Cancer Res Treat. 2010;42(2):77-81. Published online June 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.2.77

Abstract PDF PubReader ePub

Purpose

With their prolonged survival and malnutrition, cancer patients, and especially gastrointestinal (GI) tract cancer patients, can develop Wernicke's encephalopathy (WE). The aim of this study is to remind physicians of the importance of WE and prompt management in patients with GI tract cancer.

Materials and Methods

This study is a retrospective review of 2 cases of WE in advanced gastric cancer (AGC) patients, and we review the literature for cases of GI tract cancer related to WE.

Results

A 48-year-old female with AGC presented dizziness and diplopia for 5 days and a 20 kg weight loss. Neurologic exam showed nystagmus and gaze disturbance. Her symptoms improved after daily parenteral injection of thiamine 100 mg for 17 days. A 58-year-old female with AGC presented with sudden disorientation, confusion and 15 kg weight loss. Neurologic exam showed gaze limitation and mild ataxia. Despite daily parenteral injection of thiamine 100 mg for 4 days, she died 5 days after the onset of neurologic symptoms. Combining the cases noted in the literature review with our 2 cases, the 7 gastric cancer cases and 2 colorectal cancer cases related to WE showed similar clinical characteristics; 1) a history of long-period malnutrition and weight loss, 2) relatively typical neurologic signs and symptoms and 3) specific magnetic resonance image findings. Except for 2 patients who had irreversible neurologic symptoms, the other 7 patients were improved with prompt thiamine treatment.

Conclusion

It is important to consider WE in GI tract cancer patients with acute neurologic symptoms and who are in a state of malnutrition. Thiamine should be given as soon as possible when WE is suspected.

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