Radiotherapy in Ewing’s Sarcoma Family Tumor — experience from North-East India

Abstract

Introduction. The multimodality management of Ewing’s Sarcoma Family Tumors (ESFT) consists of neoadjuvant chemotherapy followed by local treatment: surgery, radiotherapy (RT) or a combination of both. The objectives of this study were to analyze disease control and overall survival in patients receiving radiotherapy as local treatment, as part of multimodality management of ESFT at our institute over a period of seven years.

Material and methods. This is a retrospective single institutional study. Hospital records were searched for patients with ESFT who received radiotherapy from January, 2012 to December, 2018. Forty-nine patients were found eligible and evaluated with respect to prognostic factors, treatment-related factors and outcomes. Time to event was measured from the date of diagnosis and survival curves were estimated by Kaplan-Meier method and log-rank test for comparison.

Results. Median follow up for patients was 18 months (range 3–81 months). Local failure/relapse was associated with worse survival. Five-year local control was 79.1% and overall survival 51.2% in the analyzed cohort. Local control did not differ significantly based on prognostic variables or treatment characteristics. Combined surgery and radiotherapy as local treatment along with good response to neoadjuvant chemotherapy were associated with significant improvement in overall survival (p-value < 0.05).

Conclusions. Combined modality local treatment with surgery and radiotherapy along with a favorable response to neoadjuvant chemotherapy are associated with improved survival in ESFT. For unresectable tumors, radiotherapy alone remains the optimum local treatment, albeit with inferior survival outcomes.