Whole Lung Irradiation for Completely Responding Pulmonary Metastases in Pediatric Ewing Sarcoma

Abstract

Aim: Scarce data assessing the real value of whole lung irradiation (WLI) in Ewing’s sarcoma (ES) with lung-only metastasis, with published conflicting results. We studied the impact of WLI in a homogenous pediatric population. Materials & methods: Retrospective study evaluating the survival outcomes of WLI in these patients. Results: Out of 163 metastatic ES; 41 patients were eligible for WLI. 30 patients (73.1%) received WLI (+ve) while 11 patients (26.8%) did not receive WLI (-ve). Five-year event-free survival was statistically significant in WLI (+ve). Five-year pulmonary relapse-free survival showed trend for improvement with WLI (+ve), while 5-year overall survival was not statistically significant between the two arms. Conclusion: WLI added significantly to the long term clinical outcome of metastatic ES patients, with no irreversible toxicity.

Keywords: :

• Ewings’ sarcoma
• lung irradiation
• lung metastasis
• pediatric sarcoma
• survival
• toxicity

Author contributions

All authors constructed the study idea and methodology. H Elghazawy, N Farid, A Nasr and MS Zaghloul retrieved the patients’ files to extract the patient data. I Zaky revised the radiological criteria for lung metastasis. N Farid underwent the statistical part. H Elghazawy, MS Zaghloul, A Nasr, M Zamzam and A Elgammal participated in writing and revising the manuscript. All authors participated in final revision and approval of all aspects of the work.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.