Radio-induced Sarcomas in Survivors of Ewing's Sarcoma

1988 ◽  
Vol 74 (5) ◽  
pp. 543-551 ◽  
Author(s):  
Stefano Boriani ◽  
Piero Picei ◽  
Alessandra Sudanese ◽  
Aldo Toni ◽  
Antonia Mancini ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Bone Tumor ◽  
Irradiation Dose ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Local Treatment ◽  
Statistical Analyses ◽  
Tumor Center ◽  
Rizzoli Orthopaedic Institute

Of 255 cases of Ewing's sarcoma recorded at the Bone Tumor Center of the Rizzoli Orthopaedic Institute, 78 patients (irradiated and with a follow-up of longer than 3 years) were considered « at risk » for the development of a second radio-induced sarcoma (RIS). Three of the 78 patients developed an RIS in the irradiated field. Theoretical and statistical analyses were carried out considering different modalities of local treatment. Statistically, the only significant factor was related to the irradiation dose. Surgical resection seems to prevent RIS.

scholarly journals Giant Calvarial Ewing's Sarcoma: A Case Report

2018 ◽  
Vol 79 (04) ◽  
pp. e79-e82
Author(s):  
Buse Sarigul ◽  
Ece Uysal ◽  
İdris Avci ◽  
Halil Peker ◽  
Suat Celik
Keyword(s):  
Case Report ◽  
Bone Tumor ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Total Removal ◽  
Primary Bone Tumor ◽  
Intracranial Involvement ◽  
Primary Bone ◽  
Parietal Bones

AbstractEwing's sarcoma (EWS) is the second most common primary bone tumor seen in children and adolescents, first being osteosarcoma. Skull lesions are seen in 6 to 9% of cases. The tumor tends to reside most frequently on frontal and parietal bones. In the literature, majority of papers on calvarial EWS present cases with intracranial involvement; extracranial extension is reported in only eight cases. The case that we are presenting in this report is a 23-year-old male patient with multiple infiltrations in femur, costal bones, and calvarium which had been diagnosed radiologically and histopathologically as EWS. The calvarial metastasis had reached a very huge size with dimensions of approximately 7.5 × 7.5 × 9.5 cm and was successfully excised totally. Twelve months of follow-up revealed no recurrence in the surgical site showing that total removal of giant cranial EWS may improve morbidity of these patients.

Neoadjuvant Chemotherapy for Localized Ewing's Sarcoma of the Extremities: Preliminary Results of a Protocol Which uses Surgery (Alone or Followed by Radiotherapy) for Local Control

1989 ◽  
Vol 75 (5) ◽  
pp. 456-462 ◽  
Author(s):  
Gaetano Bacci ◽  
Dante Dallari ◽  
Douglas McDonald ◽  
Maddalena Avella ◽  
Aldo Toni ◽  
...  
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Local Treatment ◽  
Local Therapy ◽  
Conservative Surgery ◽  
Additional Chemotherapy ◽  
Radiotherapy Alone ◽  
One Year ◽  
Almost All

From June 1983 to December 1985, thirty-eight paients with localized Ewing's sarcoma of the extremities were treated with a protocol that consisted of an initial nine week period of polychemotherapy (vincristine, adriamycin and cyclophosphamide) followed by local therapy and additional chemotherapy (vincristine, adriamycin, cyclophosphamide and dactino-mycln) for one year. As local treatment all patients were offered surgery; thirty-two accepted and six refused. These six patients were locally treated with radiotherapy alone (50 Gy). In the remaining patients an amputation was performed in one case and a resection in thirty-one. In resected patients when a wide margin was achieved (24 cases) no further local treatment was performed; when it was marginal (5 cases) or intralesional (2 cases) radiotherapy at lower doses (40 Gy) followed. At mean follow-up of thirty-seven months the percentage of continuously disease-free patients was 50 % for those treated with radiotherapy, 76 % with surgery, and 85 % with surgery and radiotherapy. Eight patients developed metastatic disease and two patients had local recurrence and metastases. The local recurrences were seen in one patient locally treated with surgery and in one locally treated with radiotherapy. Nine major local complications were observed: three in patients treated with radiotherapy, five in patients treated with surgery, and one in a patient treated with surgery and radiotherapy. These results indicate that after induction chemotherapy conservative surgery is possible in almost all cases of Ewing's sarcoma of the extremities and that such treatment is better than radiotherapy alone as local therapy.

Role of surgery in local treatment of Ewing's sarcoma of the extremities in patients undergoing adjuvant and neoadjuvant chemotherapy

2004 ◽  
Author(s):  
Gaetano Bacci ◽  
Stefano Ferrari ◽  
Alessandra Longhi ◽  
Davide Donati ◽  
Enza Barbieri ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Local Treatment

scholarly journals Precise single column resection and reconstruction with femoral head plus THR for malignant pelvic tumors

10.29007/nvsk ◽  
2018 ◽  
Author(s):  
Xiaohui Niu ◽  
Yongkun Yang ◽  
Qing Zhang ◽  
Yuan Li ◽  
Hairong Xu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Posterior Column ◽  
Surgical Margins ◽  
Wide Resection ◽  
Navigation Group ◽  
Single Column ◽  
And Function

Background Some malignant pelvic tumor may affect the anterior or posterior column at the acetabula area. The postoperative recurrenceand complication rate are high. Precise resection with safe surgical margin could cure the patients while saving healthier host bone for relative simple reconstruction.Questions/Purposes The purpose of this study is to evaluate the effect of precise single column resection and reconstruction with femoral head plus THR for malignant pelvic tumorswith respect to the (1) surgical safety, (2) oncological outcome and (3) prosthesis survivorship and function.Methods This is a clinical cases study. From 2007 to 2015, 19 patients with primary malignant tumors of the pelvis were enrolled in the study. The diagnosis included 16 cases of chondrosarcoma, 1 case of undifferentiated polymorphic sarcoma, 1 case of Ewing's sarcoma and 1 case of solitary plasmacytoma. All tumors were resected with safe surgical margins, which were proved by the postoperative specimen evaluation. Anterior column was involved in 17 cases and posterior column in 2 cases. Ten of 19 tumors were resected assisted by computer navigation. Femoral heads were used to reconstruct anterior or posterior column defects and fixed by screws; THR was used for the joint reconstruction. Oncologic outcome and function were evaluated by regular follow-up.Results The follow up time was more than 12 months in 14 cases with the average of 58.4 months (median 61, range 13-118) months. Surgical margins contained wide resection in 12 cases and marginal resection in 7 cases. The bony wide resection rate was 90% (9/10) in the navigation group and 77.8% (7/9) in free hand group respectively. One patient with Ewing's sarcoma died 14 months postoperative due to lung metastasis. There was only one case with chondrosarcoma was found recurrence in 61 months postoperatively, who was in the navigation group and having marginal margin resection. There was one prosthesis removed due to prosthesis infection (14 months postoperatively). There were another two patients with minor wound infection. The average MSTS function score was 24.8 (17-29).Conclusions The current treatment method is oncological safe and functional with less complications. The hardware is relatively cost effective and right on the shelf. However, this procedure is highly skill needed.

Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck

2011 ◽  
Vol 126 (3) ◽  
pp. 271-275
Author(s):  
S Hosokawa ◽  
J Okamura ◽  
Y Takizawa ◽  
G Takahashi ◽  
K Hosokawa ◽  
...  
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Lymphoid Tissue ◽  
Early Stage ◽  
Local Treatment ◽  
Response To Treatment ◽  
Limited Information ◽  
Early Stage Disease ◽  
First Choice

AbstractBackground:Limited information is available on mucosa-associated lymphoid tissue lymphomas arising in the head and neck.Method:A retrospective analysis was conducted of 20 patients who were histologically diagnosed with mucosa-associated lymphoid tissue lymphoma and treated at our institution between January 1990 and December 2009.Results:Treatment consisted of surgical resection alone in two patients (10 per cent), surgical resection with consecutive radiotherapy in one (5 per cent), and radiotherapy alone in eight (40 per cent). Three patients (15 per cent) were treated with systemic chemotherapy, and three (15 per cent) received chemoradiotherapy. Three patients (15 per cent) were informed of the diagnosis but not treated for their condition.Conclusion:All of the 20 patients were still alive after a mean follow-up period of 50.8 months. Local treatment for mucosa-associated lymphoid tissue lymphoma of the head and neck should be the first choice in early-stage disease. However, prolonged follow up is important to determine these patients' long-term response to treatment.

Multimodal therapy for the management of primary, nonmetastatic Ewing's sarcoma of bone: a long-term follow-up of the First Intergroup study.

1990 ◽  
Vol 8 (10) ◽  
pp. 1664-1674 ◽  
Author(s):  
M E Nesbit ◽  
E A Gehan ◽  
E O Burgert ◽  
T J Vietti ◽  
A Cangir ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Multimodal Therapy ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Patient Characteristics ◽  
Group I ◽  
Long Term Follow Up

A total of 342 previously untreated eligible children were entered into the first Intergroup Ewing's Sarcoma Study (IESS) between May 1973 and November 1978. In group I institutions, patients were randomized between treatment 1 (radiotherapy to primary lesion plus cyclophosphamide, vincristine, dactinomycin, and Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH] [VAC plus ADR]) or treatment 2 (same as treatment 1 without ADR), and group II institutions randomized patients between treatment 2 or treatment 3 (same as treatment 2 plus bilateral pulmonary radiotherapy [VAC plus BPR]). The percentages of patients relapse-free and surviving (RFS) at 5 years for treatments 1, 2, and 3 were 60%, 24%, and 44%, respectively. There was strong statistical evidence of a significant advantage in RFS for treatment 1 (VAC plus ADR) versus 2 (VAC alone) (P less than .001) and 3 (P less than .05) and also of treatment 3 versus 2 (P less than .001). Similar significant results were observed with respect to overall survival. Patients with disease at pelvic sites have significantly poorer survival at 5 years than those with disease at nonpelvic sites (34% v 57%; P less than .001). Among pelvic cases, there was no evidence of differing survival by treatment (P = .81), but among nonpelvic cases, there was strong evidence of differing survival by treatment (P less than .001). The overall percentage of patients developing metastatic disease was 44%; the percentages by treatments 1, 2, and 3 were 30%, 72%, and 42%, respectively. The overall incidence of local recurrence was 15%, and there was no evidence that local recurrence rate differed by treatment. Patient characteristics related to prognosis, both with respect to RFS and overall survival experience, were primary site (nonpelvic patients were most favorable) and patient age (younger patients were more favorable).

Ewing's Sarcoma: An Approach to Radiological Diagnosis

1979 ◽  
Vol 65 (3) ◽  
pp. 389-399 ◽  
Author(s):  
Fabrizio Lombardi ◽  
Marco Gasparini ◽  
Cristina Gianni ◽  
Raffaele Petrillo ◽  
John David Tesoro-Tess ◽  
...  
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Primary Site ◽  
Long Bones ◽  
Age Group ◽  
Pediatric Age Group ◽  
Localized Disease ◽  
The Mean ◽  
Small Bones

All the pertinent radiographs of 83 patients with histologically proven Ewing's sarcoma were reviewed. Forty-nine patients were in the pediatric age group, and 34 were adults. The mean age, the symptoms and time from symptoms to diagnosis were evaluated in the 2 groups. The site of primary involvement was in 54 % the long bones, 35 % the flat bones, 8 % the small bones and 3 % extraosseous. For the primary site we considered the diagnostic results of the standard radiographic investigations and in some cases the usefulness of angiography, xeroradiography and telethermography. At presentation we also evaluated the possible diffusion of the disease with standard radiographic surveys (chest and skeletal, including limbs) and with foot lymphography in selected cases. In this way, 57 patients (69 %) were considered to have localized disease. In this group, we also considered the value of the periodic radiographic follow-up, which enabled us to disclose the appearance of metastases (chest 64 %, bone 54 %, lymph nodes 11 %) in 28 cases (49 %). Finally, we made a comparison of the different radiologic and epidemiologic findings between children and adults.

Ewing's tumors with primary lung metastases: survival analysis of 114 (European Intergroup) Cooperative Ewing's Sarcoma Studies patients.

1998 ◽  
Vol 16 (9) ◽  
pp. 3044-3052 ◽  
Author(s):  
M Paulussen ◽  
S Ahrens ◽  
A W Craft ◽  
J Dunst ◽  
B Fröhlich ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Primary Tumor ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Lung Metastases ◽  
Local Treatment ◽  
Poor Response ◽  
Chemotherapy Response ◽  
Treatment Intensification ◽  
Lung Irradiation

PURPOSE To analyze event-free survival (EFS) and prognostic factors in patients who present with Ewing's tumors (ET) of bone and synchronous pulmonary and/or pleural metastases (ppm). PATIENTS AND METHODS Of 1,270 patients (pts) registered at the continental office of the German/European Intergroup Cooperative Ewing's Sarcoma Studies (CESS81, CESS86, EICESS92), 114 were diagnosed ET with ppm. Patients underwent neoadjuvant therapy and local treatment of the primary tumor. Whole-lung irradiation 15 to 18 Gy was applied to 75 ppm-pts. EFS and 95% confidence intervals (CIs) were estimated according to the Kaplan-Meier method, and prognostic factors were analyzed by log-rank tests and Cox and logistic regression procedures. RESULTS On November 1, 1997, at a median time under study of 5.9 years, the 5-year EFS was 0.36 (95% CI, 0.26 to 0.46) and the 10-year EFS was 0.30 (95% CI, 0.19 to 0.41). Thirty-seven of 59 (63%) first relapses involved lung and/or pleura, and the lungs were the only site of relapse in 26 of 59 (44%) ppm-pts. Risk factors identified in univariate and multivariate tests were poor response of the primary tumor toward chemotherapy, metastatic lesions in both lungs, and treatment without additional lung irradiation. CONCLUSION Chemotherapy response of the primary tumor is a prognostic factor in patients with ET with ppm. Strategies of treatment intensification warrant further evaluation.

Sign in / Sign up

Export Citation Format

Share Document