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Research Paper | Oncology Science | India | Volume 12 Issue 8, August 2023

Clinical Profile and Treatment Outcomes of Adult Ewing Sarcoma: A Tertiary Care Centre Study

Dr. Bommi Gowrisankar | Dr. Ashvin J Paul | Dr. Senthil Kumar E.

Abstract: Introduction: Ewing sarcoma (ES) is the second most common primary bone tumor. Ewing sarcoma (ES) is more common in children and relatively rare in adults. Adult ES has poor prognosis than children. Treatment approaches for adults have been extrapolated from paediatric experience. The inclusion of adults in pediatric trials was limited. Aims and Objectives: 1) To evaluate the clinical profile of Adult Ewing Sarcoma. 2) To identify risk factors for poor outcomes of Adult Ewing Sarcoma including patient, tumor, and treatment related variables. Materials and Methods: It is retrospective study. Medical records of 45 patients with age >18 years treated at our centre between 2014 and 2020, were retrospectively analysed. Survival analysis is done by plotting Kaplan?Meier curves. Results: Out of 45 patients 28 (62.2%) had localised disease, 17 (37.8%) had metastatic disease. Males were 27 (60%) and females were 18 (40%). Median age 23.6yrs. Pain (73.3%) was the most common symptom at presentation. Extremities were most common site (46.7%). Size < 8cm 28 (62.2%), > 8cm 17 (37.8%). The lung (70.6%) was the most common site of metastasis followed by the bone, bone marrow. The median number of chemotherapy cycles in the localized disease was 15 (range 1?17), and in metastatic disease, it was 8 (range 1?17). Local treatment modalities were Surgery in 9 (32.1%), RT in 19 (67.9%). Up front Surgery done in 2 patients, RT received by3 patients. Recurrence occurred in 4 patients with localised disease. Univariate analysis was done with respect to age (< 25 vs. ?25), gender, elevated or normal serum lactate dehydrogenase level, tumor size (< 8 cm versus ?8 cm), site (axial versus extremity), and neoadjuvant chemotherapy (NACT) given or not. NACT had a significant impact on overall survival (OS) and the rest had no effect. At a median follow - up of 40 months, the 3 - year OS in localized disease was 80%. In metastatic disease, no one survived at 36 months. Conclusion: With the introduction of VDC/IE regimen, survival has dramatically improved. Outcomes of localized disease are similar to that of a paediatric patients with multimodality therapy in adult ES. Metastatic ES patients still have adverse outcomes, pressing the need for additional therapies in future.

Keywords: Adult Ewing sarcoma, multi - modality therapy, Neo adjuvant chemotherapy, OS

Edition: Volume 12 Issue 8, August 2023,

Pages: 458 - 463