title: Radiotherapy in metastatic ewing sarcoma.
abstract: OBJECTIVE
  To review an institutional experience with radiotherapy (RT) in patients with metastatic Ewing sarcoma.
  
  
  METHODS
  Thirty patients with metastatic Ewing sarcoma were considered. Twenty-nine received multiagent chemotherapy, whereas 22 had local therapy, which included RT in 14, surgery in 5, and surgery followed by RT in 3.
  
  
  RESULTS
  The 5-year overall survival rate was 22.1%. On multivariate analysis, presence of uncommon sites of metastasis (brain, liver, spleen) (P<0.0001) and use of local therapy to the primary site (P<0.001) were adverse factors for survival. Local control was not achieved in the 8 patients receiving only chemotherapy. All long-term survivors had local therapy including RT to metastatic bony sites and whole-lung irradiation for pulmonary metastasis.
  
  
  CONCLUSIONS
  The presence of uncommon sites of metastasis confers a worse prognosis. Aggressive primary treatment including RT to metastatic sites should be considered in these patients.
authors.affiliation: Department of Radiation Oncology, The Methodist Hospital, Houston, TX 77030, USA. apaulino@tmhs.org
authors.forename: Arnold C
authors.initials: AC
authors.lastname: Paulino
authors.forename: Wei Y
authors.initials: WY
authors.lastname: Mai
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019046:Bone Marrow Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult