title: Ewing sarcoma in adults treated with modern radiotherapy techniques.
abstract: OBJECTIVE
  To evaluate local control and survival outcomes in adults with Ewing sarcoma (ES) treated with radiotherapy (RT).
  
  
  METHODS
  Retrospective review of all 109 patients age ⩾18 treated for ES with RT to the primary site at Memorial Sloan Kettering Cancer Center between 1990 and 2011. RT was used as the definitive local control modality in 44% of patients, preoperatively for 6%, and postoperatively for 50%.
  
  
  RESULTS
  Median age at diagnosis was 27years (range, 18-67). The 5-year local failure (LF) was 18%. Differences in LF were not identified when evaluated by modality of local control (RT versus combined surgery and RT), RT dose, fractionation, and RT technique. However, margin status at time of resection significantly predicted LF. The 5-year event-free survival and overall survival rates were 44% and 66% for patients with localized disease, compared with 16% and 26% for metastatic disease (p=0.0005 and 0.0002). Tumor size, histopathologic response to chemotherapy, and treatment on or according to a protocol were also significantly associated with survival.
  
  
  CONCLUSIONS
  This series of adults treated with modern chemotherapy and RT had prognostic factors and outcomes similar to adolescents with ES. All adults with ES should be treated with an aggressive, multidisciplinary approach.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Casey
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Meyers
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Kaled M
authors.initials: KM
authors.lastname: Alektiar
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Magnan
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Healey
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Boland
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA. Electronic address: woldens@mskcc.org.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Wolden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016609:Neoplasms, Second Primary; D011379:Prognosis; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000532:radiotherapy*; D055815:Young Adult
keywords: Adults; Ewing sarcoma; Local control; Radiation therapy