Adult Ewing's Sarcoma

[xrt123]

Do adults with soft tissue metastasis that have had a complete response to chemo still get radiation to the original GTV of metastatic sites in soft tissue? Pediatric protocols call for local therapy to all sites of disease after the consolidative chemotherapy even if there is a complete response. Is there an adult protocol people follow in this scenario? THANKS

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[Palex80]

I would do it, I am not aware of any series suggesting otherwise, provided you are still treating in a curative intent.
I've done if for lung metastases several times and once for soft tissue.

 

[taserlaser]

Do adults with soft tissue metastasis that have had a complete response to chemo still get radiation to the original GTV of metastatic sites in soft tissue? Pediatric protocols call for local therapy to all sites of disease after the consolidative chemotherapy even if there is a complete response. Is there an adult protocol people follow in this scenario? THANKS

I would echo Palex here. recently saw a young adult with a great initial response to chemo that was never referred for XRT. Relapsed at the primary site of course 😔

 

[NotMattSpraker]

Do adults with soft tissue metastasis that have had a complete response to chemo still get radiation to the original GTV of metastatic sites in soft tissue? Pediatric protocols call for local therapy to all sites of disease after the consolidative chemotherapy even if there is a complete response. Is there an adult protocol people follow in this scenario? THANKS

A lot of people treat adults with sarcoma per pediatric protocols, go for it.

 

[TheWallnerus]

I was sitting in tumor board one time with Rusty Marcus. Rusty is a peds rad onc (and had newly joined the department), but the adult sarcoma rad onc had left so we were covering that tumor board. An adult Ewings case came up. Everyone spoke, including a particularly smug med onc. Then Rusty politely offered his opinion. The particulars of the case were leading him to mention total lung RT. The med onc was super skeptical. He was like, “I don’t know about that… I’m really going to need to consult the literature.” Of course he goes and finds, I imagine to his chagrin, Rusty *is* a lot of the rad onc literature for Ewings. Next tumor board, the med onc apologized and actually ate a little crow. That was fun.

Somewhat long story short, I learned we treat adult Ewings like kids Ewings because it’s so rare and we don’t have great data to point anywhere else otherwise.

 

[xrt123]

Thanks, Sparse area to get opinions on so I appreciate the feedback

 

[Radiator20]

Little downside if you’re truly consolidating for cure. It’s Ewings, it’s a safe dose almost anywhere.