Purpose The benefit of whole-lung irradiation (WLI) for patients who have pulmonary metastases (PM) of Ewing sarcoma family tumors (ESFT) is unclear. At our institution, WLI is reserved for patients with PM that do not respond completely to induction chemotherapy. We reviewed our experience to assess the impact of WLI on clinical outcome. Patients and Methods Twenty-eight patients with ESFT and PM were treated in three consecutive institutional trials (1979-1996). Extent of pulmonary involvement at diagnosis, response of PM after induction chemotherapy, local treatment of PM thereafter, and clinical outcome were recorded. Treatment included primary tumor surgery and/or radiotherapy and 42 to 58 weeks of multiagent chemotherapy. Results Only eight patients (29%) received WLI. For the entire study group, the estimated 5-year event-free survival was 22.9% ± 9.0%; the 5-year survival was 37.3% ± 9.8%. Complete resolution of PM after induction chemotherapy was not correlated with survival (P = 0.53), nor was treatment with WLI (P = 0.87). Conclusions The comparable survival of patients with poor and good response of PM to induction chemotherapy suggests that WLI may benefit poor responders. The use of WLI in good responders may provide similar benefit and merits further study.
- Adjuvant radiotherapies
- Ewing sarcoma
- Neoplasm metastasis
- Peripheral neuroectodermal tumor
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health