A systematic review on the impact of delayed local therapy in patients with Ewing sarcoma of the pelvis.

IF 2.8 3区医学 Q3 ONCOLOGY

Journal of Cancer Research and Clinical Oncology Pub Date : 2025-08-27 DOI:10.1007/s00432-025-06286-8

Shook Fe Yap, Natacha Omer, Vivek Bhadri, Jeremy Lewin, Wayne Nicholls, Claire Carkeet, Lisa Orme, Marianne Phillips, Mark Winstanley, Smaro Lazarakis, Jasmine Mar, Angela Hong, Julie Cayrol

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Abstract

Background: Local treatment of pelvic Ewing Sarcoma (EWS) is czhallenging due to complex anatomy and potential complications. Local therapy may be deferred to maintain chemotherapy dose-intensity, but the impact of this delay on outcomes remains unclear.

Methods: A systematic review using the PICO model evaluated whether delayed local therapy affects long-term outcomes in localized pelvic EWS. Ovid Medline, Ovid Embase, and Cochrane Central databases were searched through June 2024. Studies were screened by two independent reviewers for quantitative and qualitative data extraction.

Results: Of 1849 studies screened, eight eligible studies including 2618 patients were identified; none were pelvic-specific. When specified, 1-18% had pelvic primaries. All studies were retrospective with substantial heterogeneity in endpoints. Seven of eight studies indicated delayed local therapy was associated with reduced event-free survival (EFS) and/or overall survival (OS). In the largest study (Lin et al.) of 1319 EWS patients, delayed local therapy > 16 weeks was associated with significantly reduced OS (HR 1.41, CI 1.11-1.80, p = 0.005).

Conclusion: This systematic review highlights the importance of multidisciplinary coordinated care during initial chemotherapy to optimize local therapy timing, which may impact outcomes. Further studies are needed to assess timing significance, particularly for pelvic EWS.

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骨盆尤文氏肉瘤延迟局部治疗影响的系统综述。

背景：由于复杂的解剖结构和潜在的并发症，局部治疗骨盆尤因肉瘤（EWS）具有挑战性。局部治疗可能延迟以维持化疗剂量强度，但这种延迟对结果的影响尚不清楚。方法：采用PICO模型进行系统回顾，评估局部延迟治疗是否会影响局部盆腔EWS的长期预后。Ovid Medline、Ovid Embase和Cochrane Central数据库被检索到2024年6月。研究由两名独立的审稿人筛选定量和定性数据提取。结果：在筛选的1849项研究中，确定了8项符合条件的研究，包括2618例患者；没有一个是骨盆特异性的。当有明确说明时，1-18%有盆腔原发。所有的研究都是回顾性的，在终点上有很大的异质性。8项研究中有7项表明延迟局部治疗与降低无事件生存期（EFS）和/或总生存期（OS）相关。在对1319名EWS患者进行的规模最大的研究（Lin等）中，延迟局部治疗16周与OS显著降低相关（HR 1.41, CI 1.11-1.80, p = 0.005）。结论：本系统综述强调了在初始化疗期间多学科协调护理的重要性，以优化局部治疗时机，这可能会影响结果。需要进一步的研究来评估时间的意义，特别是对于盆腔EWS。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.