title: Radiotherapy in Ewing tumors of the vertebrae: treatment results and local relapse analysis of the CESS 81/86 and EICESS 92 trials.
abstract: OBJECTIVE
  Treatment results in patients with Ewing tumors of the vertebrae enrolled in the Cooperative Ewing's Sarcoma Study (CESS) 81, 86, and the European Intergroup Cooperative Ewing's Sarcoma Study (EICESS) 92 trials were analyzed with special emphasis on radiation-associated factors.
  
  
  METHODS
  A retrospective analysis was performed on 116 patients with primary tumors of the cervical, thoracic, or lumbar vertebrae treated between 1981 and 1999. Furthermore, a relapse analysis was done on those patients who underwent radiotherapy and subsequently had a local recurrence.
  
  
  RESULTS
  A total of 64.6% of the patients received definitive radiotherapy; 27.5% of patients had surgery and radiotherapy. Only 4 patients (3.4%) underwent definitive surgery. Twenty-seven patients presented with metastases at diagnosis. 22.4% of the total group developed a local relapse. Among the subgroup with definitive radiotherapy, local recurrence was seen in 17 of 75 patients (22.6%). Event-free survival and survival at 5 years were 47% and 58%, respectively. Of the 14 evaluable patients with a local relapse after radiotherapy, 13 were in-field. No correlation between radiation dose and local control could be found.
  
  
  CONCLUSIONS
  Surgery with wide resection margins is rarely possible. The results after definitive radiotherapy in vertebral tumors are comparable to those of other tumor sites when definitive radiotherapy is given. Nearly all local relapses after radiotherapy are in-field.
authors.affiliation: Department of Radiotherapy, University Hospital of Muenster, Muenster, Germany. schuck@uni-muenster.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuck
authors.forename: Susanne
authors.initials: S
authors.lastname: Ahrens
authors.forename: Ines
authors.initials: I
authors.lastname: von Schorlemer
authors.forename: Michaela
authors.initials: M
authors.lastname: Kuhlen
authors.forename: Michael
authors.initials: M
authors.lastname: Paulussen
authors.forename: Andrea
authors.initials: A
authors.lastname: Hunold
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Winfried
authors.initials: W
authors.lastname: Winkelmann
authors.forename: Jürgen
authors.initials: J
authors.lastname: Dunst
authors.forename: Normann
authors.initials: N
authors.lastname: Willich
authors.forename: Heribert
authors.initials: H
authors.lastname: Jürgens
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome