• Arnold C Paulino, Thanh X Nguyen, Wei Y Mai, Bin S Teh, and B-Chen Wen.
• Department of Radiology, Division of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA. apaulino@tmh.tmc.edu
• Pediatr Blood Cancer. 2007 Aug 1; 49 (2): 145-8.

BackgroundTo determine prognostic factors for local control in the radiotherapeutic management of non-metastatic Ewing sarcoma.ProcedureForty patients with localized Ewing sarcoma (ES) were treated with primary site RT at one institution. Median RT dose was 55.8 Gy (range, 25.5-76 Gy). Chemotherapy was given to 34 patients (85%) with the most common regimen being vincristine, dactinomycin, cyclophosphamide, doxorubicin alternating with ifosfamide and etoposide (VACA + IE) in 10. Median follow-up for surviving patients was 12.3 years (range, 1.7-26.4 years).ResultsThe 5- and 10-year local control rate was 78.2%. On multivariate analysis, RT dose was the only prognostic factor to impact on local control. The 5- and 10-year local control rate was 88.7% for RT dose >or=49 Gy and was 37.5% for <49 Gy (P = 0.0002, log-rank test). For tumors or=49 Gy and 50.0% for RT dose <49 Gy (P = 0.01, log-rank test). For tumors >8 cm, the 5- and 10-year local control rate was 85.7% for RT dose >or=54 Gy and 26.7% for RT dose <54 Gy (P = 0.006, log-rank test).ConclusionsRadiotherapy dose was found to influence local control in ES. In particular, patients who received RT doses >or=49 Gy for tumor size or=54 Gy for tumor size >8 cm had improved local control.

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