Treatment of Lung Metastases from Ewing Sarcoma with Stereotactic Body Radiotherapy rather than Whole-Lung Irradiation

Advances in knowledge: Lung metastases from Ewing sarcoma have traditionally been treated with whole-lung irradiation (WLI) and chemotherapy. WLI may unnecessarily treat uninvolved normal lung tissue and increase the risk of toxicity. Stereotactic body radiotherapy (SBRT) has proven to be a safe and effective treatment for primary lung cancer and lung metastases, but there is no significant published description of SBRT in lung metastases from Ewing sarcoma. Implications for patient care: The patient presented in this case report had long-term survival from lung metastases of Ewing sarcoma treated with chemotherapy and SBRT. SBRT may prove to be safer and more effective than whole lung irradiation as a treatment of lung metastases in Ewing sarcoma. Summary statement: Whether SBRT of lung metastases of Ewing sarcoma can improve outcomes and decrease toxicity compared to whole-lung irradiation, surgical resection or palliative chemotherapy merits further study.