Survival outcomes in pediatric patients with metastatic Ewing sarcoma who achieve a rapid complete response of pulmonary metastases.
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Reiter Audra J, Huang Lynn, Craig Brian T, Davidoff Andrew M, Talbot Lindsay J, Coggins Jordan, Smith Jasmine, Aldrink Jennifer H, Bergus Katherine C, MacArthur Taleen A, Polites Stephanie F, Boehmer Chloe, Brungardt Joseph, Malek Marcus M, Rinehardt Hannah N, Kastenberg Zachary J, Arkin Cameron M, Gourmel Antoine, Piche Nelson, Wallace Marshall, Liang Jiancong, Lovvorn Harold N, Petroze Robin T, Gillies Gwendolyn, Marquart John P, Becktell Kerri, Le Hau D, Favela Juan, Rich Barrie S, Glick Richard D, Seemann Natashia M, Davidson Jacob, Wilson Claire A, Roach Jonathan, Brown Erin G, Doyle Kathleen E, Coakley Brian A, Emengo Pamela, Merola Pamela, Grant Christa N, Tirumani Anuritha, Tracy Elisabeth T, Moya-Mendez Mary E, Dasgupta Roshni, Lautz Timothy B, Pediatric Surgical Oncology Research Collaborative
Аннотация
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.