Whole lung irradiation in patients with exclusively pulmonary metastases of Ewing tumors
Whole lung irradiation in patients with exclusively pulmonary metastases of Ewing tumors
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DOI：
10.1007/s00066-008-1810-x
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发表时间：
2008-04-01
影响因子：
3.1
通讯作者：
Juergens, Heribert
中科院分区：
文献类型：
--
作者：
Boelling, Tobias;Schuck, Andreas;Juergens, Heribert
背景资料：在欧洲尤文氏肉瘤研究（EICESS）92中，对原发性肺转移患者进行了全肺照射（WLI）。这一回顾性分析评估肺功能和结果的患者完全肺transferation.Patients和方法：1990年和1999年之间，99例患者登记到EICESS-92研究试验与专门肺转移尤文肿瘤。多模式治疗方案包括综合化疗和原发肿瘤的局部治疗。WLI的剂量在12-21戈伊之间。70名患者接受了WLI治疗，其中13名患者接受了胸部原发性肿瘤的进一步加强治疗，累积剂量高达54戈伊。结果：37名接受WLI治疗的患者进行了肺功能测试（+/-加强）。43%、29%、21%和7%接受WLI治疗而未进一步加强剂量的患者中未观察到轻度、中度或重度肺部并发症（中位随访时间为25.2个月）。接受额外放疗或胸部手术的患者并发症发生率略高。总生存期（OAS）显示出WLI患者的结果更好的趋势（5年OAS：WLI为0.61 vs.无WLI为0.49，p = 0.36）。结论：这些数据表明，在目前的患者集体中，WLI的益处和可接受的毒性。只要没有随机前瞻性分析，目前的数据证实了WLI在原发性肺转移的尤文瘤患者中的适应症。
Background: In the European Intergroup Cooperative Ewing's Sarcoma Study (EICESS) 92, whole lung irradiation (WLI) was performed in patients with primary lung metastases. This retrospective analysis evaluates the pulmonary function and the outcome of patients with exclusively pulmonary metastases.Patients and methods: Between 1990 and 1999, 99 patients were registered into the EICESS-92-study trial with exclusively pulmonary metastases of Ewing tumors. The multimodal treatment regimen included polychemotherapy and local therapy to the primary tumor. WLI was performed with a dose between 12-21 Gy. 70 patients were treated with WLI, 13 of them received a further boost to their primary tumor in the thorax up to a cumulative dose of 54 Gy.Results: Pulmonary function tests were available for 37 patients treated with WLI (+/- boost). None, mild, moderate or severe pulmonary complications were seen in 43%, 29%, 21% and 7% of patients treated with WLI without further boost (median follow-up 25.2 months). Patients with an additional radiation boost or surgery to the thorax showed slightly higher rates of complications. Overall survival (OAS) showed a trend towards better results for patients with WLI (5-year-OAS: 0.61 for WLI vs. 0.49 for no WLI, p = 0.36).Conclusions: These data indicate a benefit and acceptable toxicity for WLI in the presented collective of patients. As long as there is no randomized prospective analysis, the present data confirm the indication for WLI in Ewing tumor patients with primary exclusively lung metastases.