Radiotherapy for Ewing sarcoma: A 5 year experience from Iran cancer institute

Background: Ewing Sarcoma Family of Tumors (ESFTs) is the second most common primary tumors of bone in childhood. The decision regarding the optimal modality for achieving local tumor control remains uncertain. The aim of this study was to report the clinical features and outcome as well as reviewing risk factors in patients. Materials and Methods: This retrospective study included 75 ESFTs patients who were treated at cancer institute between 2004 and 2009. Files of all patients with ESFTs were reviewed retrospectively and we called them for follow up. Specific data were collected with regard to the age at diagnosis, gender, tumor site and size, clinical stage, surgical procedure, plan of radiotherapy and treatment outcome (5-year and median survival). Results: The mean age at diagnosis was 21 that ranged from 1 to 52 years (SD = 9.6). The mean tumor size at diagnosis was 4.8±4.48 cm. The percent of biopsy only, partial and complete resection was 54.7% (41 patients), 6.7% (5 patients) and 37.3% (28 patients) respectively. Radiotherapy was done as definitive treatment or postoperatively (adjuvant) in 46 (61.3%) and 16 (21.4%) patients respectively. Overall 5 year survival was 24% and median survival for patients with and without metastases was 21±17 and 75±10 months. Conclusion: Presence of metastases, age at diagnosis, positive surgical margin and tumor size were the prognostic factors that influenced outcome of patients. This study suggests that radiation therapy is an acceptable local treatment modality in patients with Ewing sarcoma family.