Proton Radiation in Children with Thoracic Ewing Sarcoma: Results of the Prospective KiProReg Registry

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2025-02-03 DOI:10.1016/j.ijrobp.2024.11.037

T. Steinmeiner , C. Hansel , D. Ahmad Khalil , S. Plaude , S. Scobioala , C. Blase , S. Tippelt , S. Bauer , U. Dirksen , R. Kortmann , B. Timmermann

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引用次数: 0

Abstract

Objectives

Proton therapy (PT) is increasingly used for the treatment of thoracic Ewing sarcoma (EwS), aiming to reduce radiotherapy-related side effects. We examined pediatric patients with thoracic EwS treated with PT.

Methods

Children with localized thoracic EwS participating in the internal KiProReg registry treated at our institution between 2014 and 2023 were included. Data on patients, tumor, treatment and side effects (acc. to CTCAEv4/5) was analyzed.

Results

Twenty-eight children (14m, 14f) with a median age of 11.4 years (range 1.9-17.1) were included. Twenty-seven children received chemotherapy before and 16 concomitant to PT. Treatment concepts were adjuvant/definitive/neoadjuvant in 68%/21%/11%, respectively. Complete resection was achieved in 14 children. All children were treated locally on the primary tumor or local recurrence. Median total dose was 50.4 Gy (range 45.0-59.4 Gy). Median follow-up time after initial diagnosis was 37.5 months (range 6.6-113.3 months). Local tumor control was achieved in 25 patients (89.3%), three patients developed dissemination. In total, three patients deceased. Early higher-grade (>grade2) side-effects during PT occurred in 19 patients, predominantly on skin (n=5) and/or blood/lymphatic system (n=16). One patient developed a late fracture in the irradiated area. Among patients with ≥ 1 year FU after PT (n=20), no high-grade late cardiac/pulmonary toxicities have been observed to date.

Conclusion

PT was well tolerated in this challenging sample. Local control was achieved in the majority of patients. These results need to be confirmed with longer follow-up and in larger cohorts.

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来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.