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Title: Intraoperative Electron-Beam Radiation Therapy for Pediatric Ewing Sarcomas and Rhabdomyosarcomas: Long-Term Outcomes

Purpose: To assess long-term outcomes and toxicity of intraoperative electron-beam radiation therapy (IOERT) in the management of pediatric patients with Ewing sarcomas (EWS) and rhabdomyosarcomas (RMS). Methods and Materials: Seventy-one sarcoma (EWS n=37, 52%; RMS n=34, 48%) patients underwent IOERT for primary (n=46, 65%) or locally recurrent sarcomas (n=25, 35%) from May 1983 to November 2012. Local control (LC), overall survival (OS), and disease-free survival were estimated using Kaplan-Meier methods. For survival outcomes, potential associations were assessed in univariate and multivariate analyses using the Cox proportional hazards model. Results: After a median follow-up of 72 months (range, 4-310 months), 10-year LC, disease-free survival, and OS was 74%, 57%, and 68%, respectively. In multivariate analysis after adjustment for other covariates, disease status (P=.04 and P=.05) and R1 margin status (P<.01 and P=.04) remained significantly associated with LC and OS. Nine patients (13%) reported severe chronic toxicity events (all grade 3). Conclusions: A multimodal IOERT-containing approach is a well-tolerated component of treatment for pediatric EWS and RMS patients, allowing reduction or substitution of external beam radiation exposure while maintaining high local control rates.
Authors:
 [1] ;  [2] ;  [3] ;  [2] ;  [4] ;  [5] ;  [3] ;  [2] ;  [3] ;  [2] ;  [5]
  1. Department of Radiation Oncology, Instituto de Radiomedicina, Santiago (Chile)
  2. (Spain)
  3. School of Medicine, Complutense University, Madrid (Spain)
  4. Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid (Spain)
  5. Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain)
Publication Date:
OSTI Identifier:
22462403
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 92; Journal Issue: 5; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CONNECTIVE TISSUE; ELECTRON BEAMS; HAZARDS; MULTIVARIATE ANALYSIS; PATIENTS; PEDIATRICS; RADIOTHERAPY; RHABDOMYOSARCOMAS; TOXICITY