[Long-term results following multidisciplinary treatment of localized Ewing's sarcoma in children and adolescents].
OBJECTIVE
To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma.


METHODS
Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins.


RESULTS
Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients <or= 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients with tumors of lower volume (<or= 100 ml) had significantly better survival rates at 5 and 10 years: 82% and 60% versus 42% und 39% (p = 0.03). Seven of 52 (14%) patients experienced local failure; no significant impact was noted for any of the following factors: treatment protocol, radiation dose, surgery.


CONCLUSIONS
Radiotherapy with and without surgery of Ewing's sarcoma is a highly effective local treatment option. It seems preferable to mutilating surgery.
Ullmann
Christian
C
Strahlenklinik, Universitätsklinikum Erlangen, Erlangen.
Beck
Jörn-Dirk
JD
Holter
Wolfgang
W
Petsch
Sabrina
S
Dunst
Jürgen
J
Sauer
Rolf
R
Grabenbauer
Gerhard G
GG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D018579:Patient Selection; D011379:Prognosis; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D013997:Time Factors