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0619 / #929 Ewing Sarcoma of the Head and Neck Region: Long Term Outcomes of Multimodality Treatment

In Pediatric Blood and Cancer
By: Khanna N.
Contributor(s): Visariya B | Hotwani C | Vora T | Chinnaswamy G | Prasad M | Qureshi S | Ramadwar M | Shah S | Baheti A | Laskar S.
Material type: materialTypeLabelArticlePublisher: 2020Description: .Subject(s): Ewings sarcoma (ES) | Tata Memorial Hospital (TMH) | Head and Neck | Outcomes | Radiotherapy In: Pediatric Blood and CancerSummary: Background and Aims: To evaluate treatment response and prognostic factors for patients of non‐metastatic Ewings sarcoma (ES) of the head and neck region treated with curative intent at the Tata Memorial Hospital (TMH). Methods: From January 2009 to December 2014, 41 patients with histologically proven ES in the age group of 2 months – 50 Yrs (Median 17 Yrs) were retrospectively evaluated. Prognostic factors like age at diagnosis, sex, skeletal/ extra‐skeletal origin, primary site (PNS/non PNS), tumor size, nodes, performance status, hematological & biochemical parameters (hemoglobin, total count, lactate dehydrogenase, alkaline phosphatase and albumin), response to chemotherapy (CTh) and type of local treatment were evaluated. Results: Out of total 41, 26 (63.4%) were males and 22 (53.7%) patients had extra‐skeletal disease with a mean tumor size of 6cms. All patients received multimodal treatment in the form of EFT 2001 systemic CTh and local treatment comprising of surgery (Sx) or radiation therapy (RTh) or both. RTh alone was offered in cases where Sx was either not feasible or was deemed to be associated with significant morbidity. After a median follow‐up of 69 months, the 7‐year local control (LC), disease free survival (DFS) and overall survival (OS) were 77%, 69% and 73% respectively. At last follow up, 27 (66%) patients were alive & disease free. Three patients had local relapse only, 3 had distant metastases only, while 4 had both local relapse & distant metastases. Three patients died of treatment related toxicities. On univariate analysis, size greater than 6 cm at presentation is associated with worse prognosis in terms of OS, LR and DFS. Patients undergoing Radical RTh had similar LC, DFS & OS compared to Sx+RTh alone. Conclusions: Multimodality treatment using a combination of CTh, Sx & RTh results in optimal disease control with acceptable toxicities. Radiotherapy alone gives outcome similar to combined surgery and adjuvant radiotherapy.
TMC TMH
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Articles Articles Tata Memorial Hospital
Available AR20467

Abstracts from the 52th Congress of the International Society of Paediatric Oncology (SIOP) Virtual Congress, October 14–17, 2020

Background and Aims: To evaluate treatment response and prognostic factors for patients of non‐metastatic Ewings sarcoma (ES) of the head and neck region treated with curative intent at the Tata Memorial Hospital (TMH).

Methods: From January 2009 to December 2014, 41 patients with histologically proven ES in the age group of 2 months – 50 Yrs (Median 17 Yrs) were retrospectively evaluated. Prognostic factors like age at diagnosis, sex, skeletal/ extra‐skeletal origin, primary site (PNS/non PNS), tumor size, nodes, performance status, hematological & biochemical parameters (hemoglobin, total count, lactate dehydrogenase, alkaline phosphatase and albumin), response to chemotherapy (CTh) and type of local treatment were evaluated.

Results: Out of total 41, 26 (63.4%) were males and 22 (53.7%) patients had extra‐skeletal disease with a mean tumor size of 6cms. All patients received multimodal treatment in the form of EFT 2001 systemic CTh and local treatment comprising of surgery (Sx) or radiation therapy (RTh) or both. RTh alone was offered in cases where Sx was either not feasible or was deemed to be associated with significant morbidity. After a median follow‐up of 69 months, the 7‐year local control (LC), disease free survival (DFS) and overall survival (OS) were 77%, 69% and 73% respectively. At last follow up, 27 (66%) patients were alive & disease free. Three patients had local relapse only, 3 had distant metastases only, while 4 had both local relapse & distant metastases. Three patients died of treatment related toxicities. On univariate analysis, size greater than 6 cm at presentation is associated with worse prognosis in terms of OS, LR and DFS. Patients undergoing Radical RTh had similar LC, DFS & OS compared to Sx+RTh alone.

Conclusions: Multimodality treatment using a combination of CTh, Sx & RTh results in optimal disease control with acceptable toxicities. Radiotherapy alone gives outcome similar to combined surgery and adjuvant radiotherapy.

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