What question did this study set out to answer?

To evaluate the efficacy of radiation therapy compared to surgery as local treatment modalities in patients with localized Ewing sarcoma receiving multiagent chemotherapy.

June 1, 1991CancerOpen Access

Radiation therapy as local treatment in ewing's sarcoma. Results of the cooperative ewing's sarcoma studies cess 81 and cess 86

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Why the study?

Does the choice of local therapy (surgery vs radiation) affect relapse-free survival in patients with localized Ewing's sarcoma?

Population

215 patients with localized Ewing's sarcoma (93 from CESS 81 and 122 from CESS 86)

Comparison

Definitive radiation therapy or resection plus… vs Radical surgery combined with four courses of…

Design

Cohort, Local therapy was not randomized; however, in CESS 86, irradiated…

Follow-up

3 years

Authors

JDJürgen DunstUniversitätsklinik für Strahlentherapie RSRolf SauerUniversitätsklinikum Erlangen JBJ. M. V. BurgersHoly Cross Hospital

Discussion

Member takes

Implication

May support radiation as viable alternative to surgery for local control in Ewing sarcoma; leaves open need for randomized confirmation.

Key Points

To evaluate the efficacy of radiation therapy compared to surgery as local treatment modalities in patients with localized Ewing sarcoma receiving multiagent chemotherapy.
Analyzed protocol patients with localized Ewing sarcoma across multicenter trials in Germany, the Netherlands, Austria, and Switzerland from CESS 81 (N=93, 1981–1985) and CESS 86 (N=122, 1986–1989).
Administered 4 courses of multiagent chemotherapy combined with non-randomized local therapy: radical surgery, resection plus postoperative irradiation, or definitive radiation therapy.
In CESS 86, irradiated patients were randomized to either conventionally fractionated irradiation with less intense chemotherapy or hyperfractionated irradiation with simultaneous chemotherapy.
The overall 3-year relapse-free survival (RFS) improved from 55% in CESS 81 to 62% in CESS 86.
In CESS 81, definitive irradiation resulted in a 50% local failure rate, whereas in CESS 86, 3-year RFS reached 67% after radiation therapy, 65% after surgery, and 62% after resection plus irradiation.
In CESS 86, randomized comparison between conventional fractionation and hyperfractionated irradiation showed no significant difference in treatment outcomes.

Structured PICO

Does the choice of local therapy (surgery vs radiation) affect relapse-free survival in patients with localized Ewing's sarcoma?

Population

215 patients with localized Ewing's sarcoma (93 from CESS 81 and 122 from CESS 86)

Intervention

Definitive radiation therapy or resection plus postoperative irradiation, combined with four courses of multiagent chemotherapy

Comparator

Radical surgery combined with four courses of multiagent chemotherapy

Outcome

3-year relapse-free survival (RFS)hard clinical

Improvements in patient selection and radiation therapy quality led to comparable relapse-free survival outcomes between radiation and surgery in localized Ewing's sarcoma.

Cite This Study

Dunst et al. (1991) studied this question.

synapsesocial.com/papers/6a81a4b7bcfc941b47bf655d https://doi.org/10.1002/1097-0142(19910601)67:11<2818::aid-cncr2820671118>3.0.co;2-y

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Radiation therapy as local treatment in ewing's sarcoma. Results of the cooperative ewing's sarcoma studies cess 81 and cess 86

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Radiation therapy as local treatment in ewing's sarcoma. Results of the cooperative ewing's sarcoma studies cess 81 and cess 86

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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