TY - JOUR
T1 - Local control and sequelae in localised Ewing tumours of the spine
T2 - A French retrospective study
AU - Vogin, Guillaume
AU - Helfre, Sylvie
AU - Glorion, Christophe
AU - Mosseri, Véronique
AU - Mascard, Eric
AU - Oberlin, Odile
AU - Gaspar, Nathalie
N1 - Funding Information:
This work was partly supported by Projets Exploratoires Pluridisciplinaires (PEPS) from the Centre National de la Recherche Scientifique/Inserm/Inria “Bio-math-Info” entitled “Computational and neurophysiological bases of goal-directedandhabitlearning.”andwasperformedonanMEGplatformmemberofFranceLifeImagingnetwork
Funding Information:
This work was partly supported by Projets Exploratoires Pluridisciplinaires (PEPS) from the Centre National de la Recherche Scientifique/Inserm/Inria ?Bio-math-Info? entitled ?Computational and neurophysiological bases of goal-directed and habit learning.? and was performed on an MEG platform member of France Life Imaging network (Grant ANR-11-INBS-0006). We thank Faical Isbaine and Sophie Chen for help with the MEG experiments and Patrick Marquis and Catherine Liegeois-Chauvel for help with the SEEG experiments.
PY - 2013/4
Y1 - 2013/4
N2 - Objectives: To evaluate both local outcome and sequelae of non-metastatic spinal Ewing tumours (EWT). Patients and methods: A French cohort of patients ≤50 years with localised spinal EWT treated between 1988 and 2009, was analysed in regard to tumour characteristics (e.g. volume, vertebral compartment, spinal cord compression, paraspinal soft tissue invasion), local treatment modalities (surgery (S) and margin quality, radiotherapy (RT) dose), response to treatment (e.g. histological response to neoadjuvant chemotherapy (CT)), tumour local control (LC) and sequelae. Results: Seventy-five patients treated in successive trials were evaluated for LC: SFOP-EW88 (n = 14), SFOP-EW93 (n = 17) and EuroEwing99 (n = 44). Fifty-seven patients (79%) presented initial neurological compression and 69% had inaugural decompressive S. Local treatment modality was S + RT (n = 50), RT alone (n = 19) and S alone (n = 6). Surgery was mainly intralesional (66%). Local recurrences had occurred in 19 patients (14 local, 5 loco-regional) with a median interval of 25 months (1-50). After a 7 year median follow-up (1-22 years), the 5-year LC, relapse-free survival (RFS) and overall survival (OS) reached 78.0% (95%CI: 62.6-84.6), 57.0% (95%CI: 45.2-68.9) and 70.0% (95%CI: 59.1-81.0), respectively. Vertebral compartment involved was the only prognostic factor (5-year LC rate 100% versus 71% for favourable and unfavourable compartment, p < 0.03). Among 41 five-year survivors, we observed spinal curvature deformation (35%), growth retardation (28%), spinal reduction mobility (40%), spinal pain (25%) and neurological sequelae (32%) without any significant association with a particular local procedure. Conclusion: RT is the backbone of a successful local treatment of spinal EWT. The place of S remains a pending question. Its actual benefit will likely evolve with new available RT techniques.
AB - Objectives: To evaluate both local outcome and sequelae of non-metastatic spinal Ewing tumours (EWT). Patients and methods: A French cohort of patients ≤50 years with localised spinal EWT treated between 1988 and 2009, was analysed in regard to tumour characteristics (e.g. volume, vertebral compartment, spinal cord compression, paraspinal soft tissue invasion), local treatment modalities (surgery (S) and margin quality, radiotherapy (RT) dose), response to treatment (e.g. histological response to neoadjuvant chemotherapy (CT)), tumour local control (LC) and sequelae. Results: Seventy-five patients treated in successive trials were evaluated for LC: SFOP-EW88 (n = 14), SFOP-EW93 (n = 17) and EuroEwing99 (n = 44). Fifty-seven patients (79%) presented initial neurological compression and 69% had inaugural decompressive S. Local treatment modality was S + RT (n = 50), RT alone (n = 19) and S alone (n = 6). Surgery was mainly intralesional (66%). Local recurrences had occurred in 19 patients (14 local, 5 loco-regional) with a median interval of 25 months (1-50). After a 7 year median follow-up (1-22 years), the 5-year LC, relapse-free survival (RFS) and overall survival (OS) reached 78.0% (95%CI: 62.6-84.6), 57.0% (95%CI: 45.2-68.9) and 70.0% (95%CI: 59.1-81.0), respectively. Vertebral compartment involved was the only prognostic factor (5-year LC rate 100% versus 71% for favourable and unfavourable compartment, p < 0.03). Among 41 five-year survivors, we observed spinal curvature deformation (35%), growth retardation (28%), spinal reduction mobility (40%), spinal pain (25%) and neurological sequelae (32%) without any significant association with a particular local procedure. Conclusion: RT is the backbone of a successful local treatment of spinal EWT. The place of S remains a pending question. Its actual benefit will likely evolve with new available RT techniques.
KW - Ewing Sarcoma
KW - Local control
KW - Non-metastatic
KW - Sequelae
KW - Vertebra
UR - http://www.scopus.com/inward/record.url?scp=84875726331&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2012.12.005
DO - 10.1016/j.ejca.2012.12.005
M3 - Article
C2 - 23402991
AN - SCOPUS:84875726331
SN - 0959-8049
VL - 49
SP - 1314
EP - 1323
JO - European Journal of Cancer
JF - European Journal of Cancer
IS - 6
ER -