Survival outcomes in pediatric patients with metastatic Ewing sarcoma who achieve a rapid complete response of pulmonary metastases. Pediatr Blood Cancer 2024 Jul;71(7):e31026
Date
04/29/2024Pubmed ID
38679864Pubmed Central ID
PMC11116042DOI
10.1002/pbc.31026Scopus ID
2-s2.0-85191778083 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
PURPOSE: Our objectives were to compare overall survival (OS) and pulmonary relapse between patients with metastatic Ewing sarcoma (EWS) at diagnosis who achieve rapid complete response (RCR) and those with residual pulmonary nodules after induction chemotherapy (non-RCR).
PATIENTS AND METHODS: This retrospective cohort study included children under 20 years with metastatic EWS treated from 2007 to 2020 at 19 institutions in the Pediatric Surgical Oncology Research Collaborative. Chi-square tests were conducted for differences among groups. Kaplan-Meier curves were generated for OS and pulmonary relapse.
RESULTS: Among 148 patients with metastatic EWS at diagnosis, 61 (41.2%) achieved RCR. Five-year OS was 71.2% for patients who achieved RCR, and 50.2% for those without RCR (p = .04), and in multivariable regression among patients with isolated pulmonary metastases, RCR (hazards ratio [HR] 0.42; 95% confidence interval [CI]: 0.17-0.99) and whole lung irradiation (WLI) (HR 0.35; 95% CI: 0.16-0.77) were associated with improved survival. Pulmonary relapse occurred in 57 (37%) patients, including 18 (29%) in the RCR and 36 (41%) in the non-RCR groups (p = .14). Five-year pulmonary relapse rates did not significantly differ based on RCR (33.0%) versus non-RCR (47.0%, p = .13), or WLI (38.8%) versus no WLI (46.0%, p = .32).
DISCUSSION: Patients with EWS who had isolated pulmonary metastases at diagnosis had improved OS if they achieved RCR and received WLI, despite having no significant differences in rates of pulmonary relapse.
Author List
Reiter AJ, Huang L, Craig BT, Davidoff AM, Talbot LJ, Coggins J, Smith J, Aldrink JH, Bergus KC, MacArthur TA, Polites SF, Boehmer C, Brungardt J, Malek MM, Rinehardt HN, Kastenberg ZJ, Arkin CM, Gourmel A, Piche N, Wallace M, Liang J, Lovvorn HN 3rd, Petroze RT, Gillies G, Marquart JP, Becktell K, Le HD, Favela J, Rich BS, Glick RD, Seemann NM, Davidson J, Wilson CA, Roach J, Brown EG, Doyle KE, Coakley BA, Emengo P, Merola P, Grant CN, Tirumani A, Tracy ET, Moya-Mendez ME, Dasgupta R, Lautz TB, Pediatric Surgical Oncology Research CollaborativeAuthors
Kerri Becktell MD Associate Professor in the Pediatrics department at Medical College of WisconsinBrian T. Craig MD Assistant Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAntineoplastic Combined Chemotherapy Protocols
Bone Neoplasms
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Induction Chemotherapy
Infant
Lung Neoplasms
Male
Neoplasm Recurrence, Local
Prognosis
Remission Induction
Retrospective Studies
Sarcoma, Ewing
Survival Rate
Young Adult
