title: The role of radiotherapy in local control of nonextremity Ewing sarcomas.
abstract: OBJECTIVE
  To evaluate the results of radiotherapy and the prognostic factors affecting local control in nonextremity Ewing sarcomas.
  
  
  METHODS
  Between 1995 and 2011, 44 patients with nonextremity Ewing sarcomas were treated with radiotherapy. Tumor localizations were pelvis in 23, spine in 13, thoracic region in 5, and cranium in 3 patients. Tumor size was ≥8 cm in 56.8% of patients. Distant metastases were present in 19 of the patients at the time of diagnosis (43.1%). All patients were treated with 12 weeks of neoadjuvant chemotherapy followed by surgery and radiotherapy (45-54 Gy) or radiotherapy alone (54-64.8 Gy). Radiotherapy was applied due to microscopic residue (R1) in 5 patients after the operation and macroscopic tumor in 39 patients (macroscopic residue [R2] and nonresectable tumor).
  
  
  RESULTS
  Median follow-up was 49 months (range 9-195). Local failures developed in 7 patients (15.9%) and local control at 5 years was 81.4%. Local recurrence was detected in 6 patients (6/38) who did not have residual tumor after RT. Progression was detected in 1 patient (1/6) who had residual tumor. All those patients with local failure experienced further distant metastases. Possible prognostic factors such as age (≤17 vs &gt;17), tumor localization, tumor volume (≤8 cm vs &gt;8 cm), and M status at diagnosis (0 vs 1) were not related to local control.
  
  
  CONCLUSIONS
  Radiotherapy, either alone or adjuvant to surgery, provides local control in 80% of nonextremity Ewing sarcomas and plays an important role in treatment.
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir - Turkey.
authors.forename: Ozlem O
authors.initials: OO
authors.lastname: Akagunduz
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir - Turkey.
authors.forename: Serra A
authors.initials: SA
authors.lastname: Kamer
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir - Turkey.
authors.forename: Burcin
authors.initials: B
authors.lastname: Kececi
authors.affiliation: Department of Pediatric Oncology, Dr. Behçet Uz Children's Hospital, Izmir - Turkey.
authors.forename: Bengu
authors.initials: B
authors.lastname: Demirag
authors.affiliation: Department of Pediatric Oncology, Tepecik Training and Research Hospital, Izmir - Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Oniz
authors.affiliation: Department of Pediatric Oncology, Ege University Faculty of Medicine, Izmir - Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kantar
authors.affiliation: Department of Pediatric Oncology, Ege University Faculty of Medicine, Izmir - Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Cetingul
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir - Turkey.
authors.forename: Dundar
authors.initials: D
authors.lastname: Sabah
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir - Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Anacak
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018365:Neoplasm, Residual; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult