Nov 19, 2019

Outcomes following proton therapy for Ewing sarcoma of the cranium and skull base

Pediatric Blood & Cancer
Shivam M KharodJulie A Bradley

Abstract

Despite the dosimetric advantages of proton therapy, little data exist on patients who receive proton therapy for Ewing sarcoma of the cranium and skull base. This study reports local disease control and toxicity in such patients. We reviewed 25 patients (≤21 years old) with nonmetastatic Ewing sarcoma of the cranium and skull base treated between 2008 and 2018. Treatment toxicity was graded per the Common Terminology Criteria for Adverse Events v4.0. The Kaplan-Meier product limit method provided estimates of disease control and survival. Median patient age was 5.9 years (range, 1-21.7). Tumor subsites included the skull base (48%), non-skull-base calvarial bones (28%), paranasal sinuses (20%), and nasal cavity (4%). All patients underwent multiagent alkylator- and anthracycline-based chemotherapy; 16% underwent gross total resection (GTR) before radiation. Clinical target volume (CTV) 1 received 45 GyRBE and CTV2 received 50.4 GyRBE following GTR or 54-55.8 GyRBE following biopsy or subtotal resection. Median follow-up was 3.7 years (range, 0.26-8.3); no patients were lost. The 4-year local control, disease-free survival, and overall survival rates were 96%, 86%, and 92%, respectively. Two patients experienced in-field recurr...Continue Reading

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Mentioned in this Paper

Proton Therapy
Neuroendocrine Tumors
Follow-up
Replacement Therapy
Extra-osseous Ewing's Sarcoma Non-metastatic
Adverse Effects
Entire Base of Skull
Adverse Event
Administration of Antineoplastic Agent
Excision

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