title: Prognostic factors in head and neck Ewing sarcoma family of tumors.
abstract: OBJECTIVE
  Data on the Ewing sarcoma family of tumors (ESFT) of the head and neck region with uniform chemotherapy protocols are minimal. We evaluated outcome and prognostic factors in these patients treated with a uniform chemotherapy protocol.
  
  
  METHODS
  Single institution observational study.
  
  
  METHODS
  This is a single-institution review of patients treated between June 2003 and November 2011. Patients received neoadjuvant chemotherapy (NACT), surgery, and/or radiotherapy as a local treatment followed by adjuvant chemotherapy.
  
  
  RESULTS
  Thirty-five cases of head and neck ESFT were treated with a uniform chemotherapy protocol. The median age was 12 years (range, 1-43 years); three (9%) had metastases. Nine patients underwent surgery, of which eight received adjuvant radiotherapy; 23 received definitive radiotherapy post-NACT. At a median follow-up of 58 months (range. 3.7-133.7 months), 5-year event-free survival (EFS), overall survival (OS), and local control rate were 55.1 ± 9.2%, 68.3 ± 8.3%, and 74.1 ± 8.5%, respectively. Multivariate analysis showed that baseline white blood cell (WBC) count independently prognosticated EFS (P = .04), with patients who had WBC ≤11,000/µL had superior EFS, although no difference for OS was observed.
  
  
  CONCLUSIONS
  This is one of the largest studies of head and neck ESFT treated with a uniform chemotherapy protocol with intent-to-treat analysis. Within the limitations of the small size, baseline low WBC count appeared to have a superior outcome.
authors.affiliation: Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Bivas
authors.initials: B
authors.lastname: Biswas
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
authors.forename: Bidhu K
authors.initials: BK
authors.lastname: Mohanti
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Vishnubhatla
authors.forename: Sameer
authors.initials: S
authors.lastname: Bakhshi
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ewing sarcoma; Head and neck; chemotherapy; outcome; prognostic factors