Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Extraction
2.2. Analyzed Parameters
2.3. Data Interpretation
2.4. Endpoints
2.5. Statistical Analysis
3. Results
3.1. Patients Characteristics
3.2. Radiotherapy Characteristics
3.3. Response to Radiotherapy
3.4. Survival
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Value | |
---|---|---|
Age at diagnosis | Median | 28.1 |
Interquartile range | 7.5–48.8 | |
Number of patients (%) | ||
Sex | Female | 53 (42.1) |
Male | 73 (57.9) | |
Primary site | Head and neck | 16 (12.7) |
Thorax | 5 (4) | |
Pelvis | 22 (17.5) | |
Upper arm | 18 (14.3) | |
Thigh | 38 (30.2) | |
Calf | 15 (11.9) | |
Spine | 12 (9.5) | |
Osteosarcoma pathological subtype 1 | Osteoblastic | 38 (26.4) |
Chondroblastic | 22 (15.3) | |
Fibroblastic | 8 (5.6) | |
Intramedullary/intraosseus | 3 (2.1) | |
Small cell | 3 (2.1) | |
Extraskeletal | 4 (2.8) | |
High-grade surface | 2 (1.4) | |
Telangiectatic | 3 (2.1) | |
Parosteal | 2 (1.4) | |
Periosteal | 1 (0.7) | |
Postradiation | 5 (3.5) | |
No data | 53 (36.8) | |
Underwent curative surgery | Yes | 97 (77) |
No | 29 (23) | |
Underwent perioperative chemotherapy | Yes | 87 (69) |
No | 10 (7.9) | |
Not applicable | 29 (23) | |
Distant metastases at the moment of diagnosis | Yes | 32 (25.4) |
No | 94 (74.6) | |
Number of radiotherapy treatments | 1 | 88 (69.8) |
2 | 25 (19.8) | |
3 | 11 (8.7) | |
4 | 1 (0.8) | |
6 | 1 (0.8) |
Parameter | Palliative | Non-Palliative | |||||
---|---|---|---|---|---|---|---|
2000–2010 n = 33 | 2011–2020 n = 78 | p-Value | 2000–2010 n = 16 | 2011–2020 n = 54 | p-Value | ||
Technique (%) | 2D | 26 (78.8) | 38 (48.7) | 0.006 | 2 (12.5) | 2 (3.7) | 0.044 |
3D | 7 (21.2) | 28 (35.9) | 8 (50.0) | 10 (18.5) | |||
IMRT/VMAT | 0 | 12 (15.4) | 3 (18.8) | 24 (44.4) | |||
SBRT/SRS | 0 | 0 | 3 (18.8) | 15 (27.8) | |||
PT | 0 | 0 | 0 | 3 (5.6) | |||
Target volume (%) | Primary tumor | 2 (6.1) | 16 (20.5) | 0.093 | 10 (62.5) | 16 (29.6) | 0.055 |
Recurrent tumor | 5 (15.2) | 16 (20.5) | 1 (6.2) | 9 (16.7) | |||
Metastatic lesion(s) | 26 (78.8) | 46 (59.0) | 5 (31.2) | 29 (53.7) | |||
Site (%) | CNS | 0 | 10 (12.8) | 0.084 | 1 (6.2) | 2 (3.7) | 0.820 |
Head and neck | 2 (6.1) | 2 (2.6) | 3 (18.8) | 12 (22.2) | |||
Thorax | 10 (30.3) | 10 (12.8) | 4 (25.0) | 17 (31.5) | |||
Abdomen | 0 | 0 | 0 | 2 (3.7) | |||
Pelvis | 9 (27.3) | 19 (24.4) | 5 (31.2) | 9 (16.7) | |||
Spine | 7 (21.2) | 20 (25.6) | 3 (18.8) | 8 (14.8) | |||
Upper extremity | 4 (12.1) | 8 (10.3) | 0 | 1 (1.9) | |||
Lower extremity | 1 (3.0) | 9 (11.5) | 0 | 3 (5.6) | |||
Median EQD2 in Gy (IQR) | 26.7 (6–26.7) | 26.7 (6.7–26.7) | 0.044 * | 42 (41.1–50.6) | 59.8 (38.6–70) | 0.071 | |
Median fraction dose in Gy (IQR) | 4 (4–8) | 4 (4–4) | 0.302 | 3 (2.8–4) | 3 (2–5) | 0.815 | |
Concurrent systemic treatment (%) | Yes | 6 (18.2) | 19 (24.4) | 0.643 | 1 (6.2) | 15 (27.8) | 0.144 |
No | 27 (81.8) | 59 (75.6) | 15 (93.8) | 39 (72.2) |
Parameter | In-Field Progression n = 14 | Without In-Field Progression n = 56 | p-Value | |
---|---|---|---|---|
Technique (%) | 2D | 0 (0.0) | 4 (7.1) | 0.418 |
3D | 2 (14.3) | 16 (28.6) | ||
IMRT/VMAT | 8 (57.1) | 19 (33.9) | ||
SBRT/SRS | 3 (21.4) | 15 (26.8) | ||
PT | 1 (7.1) | 2 (3.6) | ||
Intent (%) | Adjuvant R0 | 0 (0.0) | 4 (7.1) | 0.02 |
Adjuvant R1/R2 | 3 (21.4) | 18 (32.1) | ||
Definitive unresectable | 5 (35.7) | 8 (14.3) | ||
Neoadjuvant | 0 (0.0) | 3 (5.4) | ||
Oligometastatic | 4 (28.6) | 23 (41.1) | ||
Oligoprogressive | 2 (14.3) | 0 (0.0) | ||
Site (%) | CNS | 0 | 3 (5.4) | 0.734 |
Head and neck | 4 (28.6) | 11 (19.6) | ||
Thorax | 3 (21.4) | 18 (32.1) | ||
Abdomen | 1 (7.1) | 1 (1.8) | ||
Pelvis | 4 (28.6) | 10 (17.9) | ||
Spine | 2 (14.3) | 9 (16.1) | ||
Upper extremity | 0 | 1 (1.8) | ||
Lower extremity | 0 | 3 (5.4) | ||
Median EQD2 in Gy (IQR) | 60 (4–70) | 50 (38.3–68.4) | 0.566 | |
Median fraction dose in Gy (IQR) | 2.5 (2–4.8) | 3 (2.2–5) | 0.153 | |
Concurrent systemic treatment (%) | Yes | 5 (35.7) | 11 (19.6) | 0.355 |
No | 9 (64.3) | 45 (80.4) |
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Spałek, M.J.; Poleszczuk, J.; Czarnecka, A.M.; Dudzisz-Śledź, M.; Napieralska, A.; Matysiakiewicz, J.; Chojnacka, M.; Raciborska, A.; Sztuder, A.; Maciejczyk, A.; et al. Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis. Cells 2021, 10, 366. https://doi.org/10.3390/cells10020366
Spałek MJ, Poleszczuk J, Czarnecka AM, Dudzisz-Śledź M, Napieralska A, Matysiakiewicz J, Chojnacka M, Raciborska A, Sztuder A, Maciejczyk A, et al. Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis. Cells. 2021; 10(2):366. https://doi.org/10.3390/cells10020366
Chicago/Turabian StyleSpałek, Mateusz Jacek, Jan Poleszczuk, Anna Małgorzata Czarnecka, Monika Dudzisz-Śledź, Aleksandra Napieralska, Jacek Matysiakiewicz, Marzanna Chojnacka, Anna Raciborska, Aleksandra Sztuder, Adam Maciejczyk, and et al. 2021. "Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis" Cells 10, no. 2: 366. https://doi.org/10.3390/cells10020366