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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004458naa a2200697 4500
001oai:gup.ub.gu.se/328646
003SwePub
008240528s2023 | |||||||||||000 ||eng|
024a https://gup.ub.gu.se/publication/3286462 URI
024a https://doi.org/10.1016/j.adro.2023.1012692 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Kersting, J.4 aut
2451 0a Effect of Radiotherapy Dose on Outcome in Nonmetastatic Sarcoma
264 1c 2023
520 a Purpose: Radiation therapy (RT) is an integral part of Ewing sarcoma (EwS) therapy. The Ewing 2008 protocol recommended RT doses ranging from 45 to 54 Gy. However, some patients received other doses of RT. We analyzed the effect of different RT doses on event-free survival (EFS) and overall survival (OS) in patients with EwS.Methods and Materials: The Ewing 2008 database included 528 RT-admitted patients with nonmetastatic EwS. Recommended multimodal therapy consisted of multiagent chemotherapy and local treatment consisting of surgery (S & RT group) and/or RT (RT group). EFS and OS were analyzed with uni-and multivariable Cox regression models including known prognostic factors such as age, sex, tumor volume, surgical margins, and histologic response.Results: S & RT was performed in 332 patients (62.9%), and 145 patients (27.5%) received definitive RT. Standard dose =53 Gy (d1) was admitted in 57.8%, high dose of 54 to 58 Gy (d2) in 35.5%, and very high dose > 59 Gy (d3) in 6.6% of patients. In the RT group, RT dose was d1 in 11.7%, d2 in 44.1%, and d3 in 44.1% of patients. Three-year EFS in the S & RT group was 76.6% for d1, 73.7% for d2, and 68.2% for d3 (P = .42) and in the RT group 52.9%, 62.5%, and 70.3% (P = .63), respectively. Multivariable Cox regression revealed age > 15 years (hazard ratio [HR], 2.68; 95% confidence interval [CI], 1.63-4.38) and nonradical margins (HR, 1.76; 95% CI, 1.05-2.93) for the S & RT group (sex, P = .96; histologic response, P = .07; tumor volume, P = .50; dose, P = .10) and large tumor volume (HR, 2.20; 95% CI, 1.21-4.0) for the RT group as independent factors (dose, P = .15; age, P = .08; sex, P = .40).Conclusions: In the combined local therapy modality group, treatment with higher RT dose had an effect on EFS, whereas higher dose of radiation when treated with definitive RT was associated with an increased OS. Indications for selection biases for dosage were found. Upcoming trials will assess the value of different RT doses in a randomized manner to control for potential selection bias.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
653 a localized ewing sarcoma
653 a prognostic-factors
653 a tumors
653 a therapy
653 a bone
653 a chemotherapy
653 a management
653 a children
653 a survival
653 a part
653 a Oncology
653 a Radiology
653 a Nuclear Medicine & Medical Imaging
700a Ranft, A.4 aut
700a Bhadri, V.4 aut
700a Brichard, B.4 aut
700a Collaud, S.4 aut
700a Cyprova, S.4 aut
700a Eich, H.4 aut
700a Ek, Torben,d 1963u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics4 aut0 (Swepub:gu)xektoa
700a Gelderblom, H.4 aut
700a Hardes, J.4 aut
700a Haveman, L.4 aut
700a Hartmann, W.4 aut
700a Hauser, P.4 aut
700a Heesen, P.4 aut
700a Jurgens, H.4 aut
700a Kanerva, J.4 aut
700a Kuhne, T.4 aut
700a Raciborska, A.4 aut
700a Rascon, J.4 aut
700a Rechl, V.4 aut
700a Streitburger, A.4 aut
700a Timmermann, B.4 aut
700a Uhlenbruch, Y.4 aut
700a Dirksen, U.4 aut
710a Göteborgs universitetb Institutionen för kliniska vetenskaper, Avdelningen för pediatrik4 org
773t Advances in Radiation Oncologyg 8:4q 8:4
8564 8u https://gup.ub.gu.se/publication/328646
8564 8u https://doi.org/10.1016/j.adro.2023.101269

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