Pencil beam scanned protons for the treatment of patients with Ewing sarcoma
Background Few data exist regarding the clinical outcome of patients with Ewing sarcoma (EWS) treated with pencil beam scanning proton therapy (PT). We report the outcome of children, adolescents and young adults (AYA) treated with PT at the Paul Scherrer Institute. Materials Thirty‐eight patients (...
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| Veröffentlicht in: | Pediatric blood & cancer 2017-12, Vol.64 (12), p.n/a |
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| creator | Weber, Damien C. Murray, Fritz R. Correia, Dora Bolsi, Alessandra Frei‐Welte, Martina Pica, Alessia Lomax, Antony J. Schneider, Ralf Bachtiary, Barbara |
| description | Background
Few data exist regarding the clinical outcome of patients with Ewing sarcoma (EWS) treated with pencil beam scanning proton therapy (PT). We report the outcome of children, adolescents and young adults (AYA) treated with PT at the Paul Scherrer Institute.
Materials
Thirty‐eight patients (median age, 9.9 years) received a median dose of 54.9 Gy(RBE) (where RBE is relative biologic effectiveness). Size of the tumor ranged from 1.7 to 24 cm. Most common primary site was axial/pelvic (n = 27; 71%). Four patients (11%) presented with metastases at diagnosis. Twenty (53%) patients had chemo‐PT only. Median follow‐up was 49.6 months (range, 9.2–131.7).
Results
The 5‐year actuarial rate of local control (LC), distant metastasis‐free survival (DMFS), and overall survival (OS) were 81.5%, 76.4%, and 83.0%, respectively. All local recurrences occurred in field and in patients with nonextremity primaries. Six patients died, all of tumor progression. Age < 10 years was a favorable factor of borderline significance for LC (P = 0.05) and OS (P = 0.05), but was significant for DMFS (P = 0.003). Tumor volume |
| doi_str_mv | 10.1002/pbc.26688 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1952199949</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1952199949</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-692c2bfa4e35122dce0c504c0cc4696de8babf633ee9391e21f19edec2bca18e3</originalsourceid><addsrcrecordid>eNp1kMtOAjEUhhujEUQXvoBp4srFQC_TMl0qwUtCIgtdN53OGRnCXGxLCG9PdZCdq_MvvvOdkx-hW0rGlBA26XI7ZlJm2RkaUpGKRBA6PT9logboyvt1RCUR2SUasEyyKSFkiBZLaGy1wTmYGntrmgYK3Lk2tI3HZetwWAEODkyooQm4LXFnQhWjx7sqrPB8VzVf2Btn29pco4vSbDzcHOcIfT7PP2avyeL95W32uEgsFzxLpGKW5aVJgQvKWGGBWEFSS6xNpZIFZLnJS8k5gOKKAqMlVVBAXLKGZsBH6L73xke_t-CDXrdb18STmirBqFIqVZF66CnrWu8dlLpzVW3cXlOif3rTsTf921tk747GbV5DcSL_iorApAd21Qb2_5v08mnWKw8g7Hda</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1952199949</pqid></control><display><type>article</type><title>Pencil beam scanned protons for the treatment of patients with Ewing sarcoma</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Weber, Damien C. ; Murray, Fritz R. ; Correia, Dora ; Bolsi, Alessandra ; Frei‐Welte, Martina ; Pica, Alessia ; Lomax, Antony J. ; Schneider, Ralf ; Bachtiary, Barbara</creator><creatorcontrib>Weber, Damien C. ; Murray, Fritz R. ; Correia, Dora ; Bolsi, Alessandra ; Frei‐Welte, Martina ; Pica, Alessia ; Lomax, Antony J. ; Schneider, Ralf ; Bachtiary, Barbara</creatorcontrib><description>Background
Few data exist regarding the clinical outcome of patients with Ewing sarcoma (EWS) treated with pencil beam scanning proton therapy (PT). We report the outcome of children, adolescents and young adults (AYA) treated with PT at the Paul Scherrer Institute.
Materials
Thirty‐eight patients (median age, 9.9 years) received a median dose of 54.9 Gy(RBE) (where RBE is relative biologic effectiveness). Size of the tumor ranged from 1.7 to 24 cm. Most common primary site was axial/pelvic (n = 27; 71%). Four patients (11%) presented with metastases at diagnosis. Twenty (53%) patients had chemo‐PT only. Median follow‐up was 49.6 months (range, 9.2–131.7).
Results
The 5‐year actuarial rate of local control (LC), distant metastasis‐free survival (DMFS), and overall survival (OS) were 81.5%, 76.4%, and 83.0%, respectively. All local recurrences occurred in field and in patients with nonextremity primaries. Six patients died, all of tumor progression. Age < 10 years was a favorable factor of borderline significance for LC (P = 0.05) and OS (P = 0.05), but was significant for DMFS (P = 0.003). Tumor volume <200 ml was a significant prognostic factors for DMFS (P = 0.03), but not for OS (P = 0.07). Metastasis at diagnosis was a strong predictor of local failure (P = 0.003). Only two grade 3 late toxicities were observed. The 5‐year actuarial rate of grade 3 toxicity‐free survival was 90.9%.
Conclusions
These preliminary data suggest that the outcomes of children and AYA with EWS are good and PT was well tolerated with few late adverse events. The local and distant tumor control for older patients with large pre‐PT tumor volumes remains problematic.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.26688</identifier><identifier>PMID: 28627000</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adolescents ; Adult ; AYA ; Bone Neoplasms - mortality ; Bone Neoplasms - pathology ; Bone Neoplasms - radiotherapy ; Child ; Child, Preschool ; Children ; Ewing sarcoma ; Ewing's sarcoma ; Ewings sarcoma ; Female ; Hematology ; Humans ; Infant ; late toxicity ; local tumor control ; Male ; Medical prognosis ; Metastases ; Metastasis ; Oncology ; Patients ; Pediatrics ; pencil beam scanned protons ; Proton Therapy ; Protons ; Sarcoma ; Sarcoma, Ewing - mortality ; Sarcoma, Ewing - pathology ; Sarcoma, Ewing - radiotherapy ; Survival ; Toxicity ; Tumor Burden ; Young Adult ; Young adults</subject><ispartof>Pediatric blood & cancer, 2017-12, Vol.64 (12), p.n/a</ispartof><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-692c2bfa4e35122dce0c504c0cc4696de8babf633ee9391e21f19edec2bca18e3</citedby><cites>FETCH-LOGICAL-c3538-692c2bfa4e35122dce0c504c0cc4696de8babf633ee9391e21f19edec2bca18e3</cites><orcidid>0000-0003-1166-8236</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.26688$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.26688$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28627000$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weber, Damien C.</creatorcontrib><creatorcontrib>Murray, Fritz R.</creatorcontrib><creatorcontrib>Correia, Dora</creatorcontrib><creatorcontrib>Bolsi, Alessandra</creatorcontrib><creatorcontrib>Frei‐Welte, Martina</creatorcontrib><creatorcontrib>Pica, Alessia</creatorcontrib><creatorcontrib>Lomax, Antony J.</creatorcontrib><creatorcontrib>Schneider, Ralf</creatorcontrib><creatorcontrib>Bachtiary, Barbara</creatorcontrib><title>Pencil beam scanned protons for the treatment of patients with Ewing sarcoma</title><title>Pediatric blood & cancer</title><addtitle>Pediatr Blood Cancer</addtitle><description>Background
Few data exist regarding the clinical outcome of patients with Ewing sarcoma (EWS) treated with pencil beam scanning proton therapy (PT). We report the outcome of children, adolescents and young adults (AYA) treated with PT at the Paul Scherrer Institute.
Materials
Thirty‐eight patients (median age, 9.9 years) received a median dose of 54.9 Gy(RBE) (where RBE is relative biologic effectiveness). Size of the tumor ranged from 1.7 to 24 cm. Most common primary site was axial/pelvic (n = 27; 71%). Four patients (11%) presented with metastases at diagnosis. Twenty (53%) patients had chemo‐PT only. Median follow‐up was 49.6 months (range, 9.2–131.7).
Results
The 5‐year actuarial rate of local control (LC), distant metastasis‐free survival (DMFS), and overall survival (OS) were 81.5%, 76.4%, and 83.0%, respectively. All local recurrences occurred in field and in patients with nonextremity primaries. Six patients died, all of tumor progression. Age < 10 years was a favorable factor of borderline significance for LC (P = 0.05) and OS (P = 0.05), but was significant for DMFS (P = 0.003). Tumor volume <200 ml was a significant prognostic factors for DMFS (P = 0.03), but not for OS (P = 0.07). Metastasis at diagnosis was a strong predictor of local failure (P = 0.003). Only two grade 3 late toxicities were observed. The 5‐year actuarial rate of grade 3 toxicity‐free survival was 90.9%.
Conclusions
These preliminary data suggest that the outcomes of children and AYA with EWS are good and PT was well tolerated with few late adverse events. The local and distant tumor control for older patients with large pre‐PT tumor volumes remains problematic.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adult</subject><subject>AYA</subject><subject>Bone Neoplasms - mortality</subject><subject>Bone Neoplasms - pathology</subject><subject>Bone Neoplasms - radiotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Ewing sarcoma</subject><subject>Ewing's sarcoma</subject><subject>Ewings sarcoma</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Infant</subject><subject>late toxicity</subject><subject>local tumor control</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Oncology</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>pencil beam scanned protons</subject><subject>Proton Therapy</subject><subject>Protons</subject><subject>Sarcoma</subject><subject>Sarcoma, Ewing - mortality</subject><subject>Sarcoma, Ewing - pathology</subject><subject>Sarcoma, Ewing - radiotherapy</subject><subject>Survival</subject><subject>Toxicity</subject><subject>Tumor Burden</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtOAjEUhhujEUQXvoBp4srFQC_TMl0qwUtCIgtdN53OGRnCXGxLCG9PdZCdq_MvvvOdkx-hW0rGlBA26XI7ZlJm2RkaUpGKRBA6PT9logboyvt1RCUR2SUasEyyKSFkiBZLaGy1wTmYGntrmgYK3Lk2tI3HZetwWAEODkyooQm4LXFnQhWjx7sqrPB8VzVf2Btn29pco4vSbDzcHOcIfT7PP2avyeL95W32uEgsFzxLpGKW5aVJgQvKWGGBWEFSS6xNpZIFZLnJS8k5gOKKAqMlVVBAXLKGZsBH6L73xke_t-CDXrdb18STmirBqFIqVZF66CnrWu8dlLpzVW3cXlOif3rTsTf921tk747GbV5DcSL_iorApAd21Qb2_5v08mnWKw8g7Hda</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Weber, Damien C.</creator><creator>Murray, Fritz R.</creator><creator>Correia, Dora</creator><creator>Bolsi, Alessandra</creator><creator>Frei‐Welte, Martina</creator><creator>Pica, Alessia</creator><creator>Lomax, Antony J.</creator><creator>Schneider, Ralf</creator><creator>Bachtiary, Barbara</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><orcidid>https://orcid.org/0000-0003-1166-8236</orcidid></search><sort><creationdate>201712</creationdate><title>Pencil beam scanned protons for the treatment of patients with Ewing sarcoma</title><author>Weber, Damien C. ; Murray, Fritz R. ; Correia, Dora ; Bolsi, Alessandra ; Frei‐Welte, Martina ; Pica, Alessia ; Lomax, Antony J. ; Schneider, Ralf ; Bachtiary, Barbara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-692c2bfa4e35122dce0c504c0cc4696de8babf633ee9391e21f19edec2bca18e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Adult</topic><topic>AYA</topic><topic>Bone Neoplasms - mortality</topic><topic>Bone Neoplasms - pathology</topic><topic>Bone Neoplasms - radiotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Ewing sarcoma</topic><topic>Ewing's sarcoma</topic><topic>Ewings sarcoma</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Infant</topic><topic>late toxicity</topic><topic>local tumor control</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Oncology</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>pencil beam scanned protons</topic><topic>Proton Therapy</topic><topic>Protons</topic><topic>Sarcoma</topic><topic>Sarcoma, Ewing - mortality</topic><topic>Sarcoma, Ewing - pathology</topic><topic>Sarcoma, Ewing - radiotherapy</topic><topic>Survival</topic><topic>Toxicity</topic><topic>Tumor Burden</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weber, Damien C.</creatorcontrib><creatorcontrib>Murray, Fritz R.</creatorcontrib><creatorcontrib>Correia, Dora</creatorcontrib><creatorcontrib>Bolsi, Alessandra</creatorcontrib><creatorcontrib>Frei‐Welte, Martina</creatorcontrib><creatorcontrib>Pica, Alessia</creatorcontrib><creatorcontrib>Lomax, Antony J.</creatorcontrib><creatorcontrib>Schneider, Ralf</creatorcontrib><creatorcontrib>Bachtiary, Barbara</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Pediatric blood & cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weber, Damien C.</au><au>Murray, Fritz R.</au><au>Correia, Dora</au><au>Bolsi, Alessandra</au><au>Frei‐Welte, Martina</au><au>Pica, Alessia</au><au>Lomax, Antony J.</au><au>Schneider, Ralf</au><au>Bachtiary, Barbara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pencil beam scanned protons for the treatment of patients with Ewing sarcoma</atitle><jtitle>Pediatric blood & cancer</jtitle><addtitle>Pediatr Blood Cancer</addtitle><date>2017-12</date><risdate>2017</risdate><volume>64</volume><issue>12</issue><epage>n/a</epage><issn>1545-5009</issn><eissn>1545-5017</eissn><abstract>Background
Few data exist regarding the clinical outcome of patients with Ewing sarcoma (EWS) treated with pencil beam scanning proton therapy (PT). We report the outcome of children, adolescents and young adults (AYA) treated with PT at the Paul Scherrer Institute.
Materials
Thirty‐eight patients (median age, 9.9 years) received a median dose of 54.9 Gy(RBE) (where RBE is relative biologic effectiveness). Size of the tumor ranged from 1.7 to 24 cm. Most common primary site was axial/pelvic (n = 27; 71%). Four patients (11%) presented with metastases at diagnosis. Twenty (53%) patients had chemo‐PT only. Median follow‐up was 49.6 months (range, 9.2–131.7).
Results
The 5‐year actuarial rate of local control (LC), distant metastasis‐free survival (DMFS), and overall survival (OS) were 81.5%, 76.4%, and 83.0%, respectively. All local recurrences occurred in field and in patients with nonextremity primaries. Six patients died, all of tumor progression. Age < 10 years was a favorable factor of borderline significance for LC (P = 0.05) and OS (P = 0.05), but was significant for DMFS (P = 0.003). Tumor volume <200 ml was a significant prognostic factors for DMFS (P = 0.03), but not for OS (P = 0.07). Metastasis at diagnosis was a strong predictor of local failure (P = 0.003). Only two grade 3 late toxicities were observed. The 5‐year actuarial rate of grade 3 toxicity‐free survival was 90.9%.
Conclusions
These preliminary data suggest that the outcomes of children and AYA with EWS are good and PT was well tolerated with few late adverse events. The local and distant tumor control for older patients with large pre‐PT tumor volumes remains problematic.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28627000</pmid><doi>10.1002/pbc.26688</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1166-8236</orcidid></addata></record> |
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| subjects | Adolescent Adolescents Adult AYA Bone Neoplasms - mortality Bone Neoplasms - pathology Bone Neoplasms - radiotherapy Child Child, Preschool Children Ewing sarcoma Ewing's sarcoma Ewings sarcoma Female Hematology Humans Infant late toxicity local tumor control Male Medical prognosis Metastases Metastasis Oncology Patients Pediatrics pencil beam scanned protons Proton Therapy Protons Sarcoma Sarcoma, Ewing - mortality Sarcoma, Ewing - pathology Sarcoma, Ewing - radiotherapy Survival Toxicity Tumor Burden Young Adult Young adults |
| title | Pencil beam scanned protons for the treatment of patients with Ewing sarcoma |
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