Radiation for bone metastases in Ewing sarcoma and rhabdomyosarcoma Journal Article


Authors: Casey, D. L.; Wexler, L. H.; Meyers, P. A.; Magnan, H.; Chou, A. J.; Wolden, S. L.
Article Title: Radiation for bone metastases in Ewing sarcoma and rhabdomyosarcoma
Abstract: Background: The role, optimal dose, and efficacy of radiotherapy (RT) for the treatment of bone metastases in rhabdomyosarcoma (RMS) and Ewing sarcoma (ES) are unclear. Procedure: All patients with ES or RMS who received RT for bone metastases with curative intent during frontline therapy at Memorial Sloan Kettering Cancer Center (MSKCC) between 1995 and 2013 were reviewed. Among the 30 patients (8 RMS and 22 ES), 49 bone metastases were irradiated. Results: Median biologically effective dose (BED) was 42.4Gy (range, 34.9-59.7) for RMS and 50.7Gy (range, 31.3-65.8) for ES. Tumor recurrence occurred in six of 49 irradiated bone metastases. Cumulative incidence of local failure at a treated metastatic site was 6.6% at 1 year and 9.0% at 3 years. Dose, fractionation, and RT technique did not impact local control at an irradiated site. The presence of >5 bone metastases was associated with worse local control at an irradiated site (P=0.07). The 3-year EFS was 33% in RMS and 16% in ES. Conclusions: RT appears to be an effective modality of local control for bone metastases in ES and RMS. Local control at sites of metastatic bone irradiation is similar to local control at the primary site after definitive RT. Doses in the biologic range prescribed for the definitive treatment of primary disease should be used for metastatic sites of disease.
Keywords: adolescent; clinical article; cancer surgery; treatment failure; fatigue; doxorubicin; diarrhea; dose response; bone metastasis; cancer radiotherapy; radiation dose; etoposide; esophagitis; mucosa inflammation; nausea; vomiting; incidence; cyclophosphamide; vincristine; ifosfamide; coughing; ewing sarcoma; dysphagia; radiation oncology; radiation dose fractionation; tumor recurrence; irradiation; bone; dactinomycin; dermatitis; cancer control; rhabdomyosarcoma; cystitis; proctitis; human; male; female; priority journal; article
Journal Title: Pediatric Blood and Cancer
Volume: 62
Issue: 3
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Date Published: 2015-03-01
Start Page: 445
End Page: 449
Language: English
DOI: 10.1002/pbc.25294
PROVIDER: scopus
PUBMED: 25346208
PMCID: PMC5045248
DOI/URL:
Notes: Export Date: 2 March 2015 -- Source: Scopus
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MSK Authors
  1. Suzanne L Wolden
    560 Wolden
  2. Leonard H Wexler
    191 Wexler
  3. Alexander Ja-Ho Chou
    58 Chou
  4. Paul Meyers
    311 Meyers
  5. Heather Magnan
    31 Magnan
  6. Dana   Casey
    55 Casey