Risk stratification of pulmonary toxicities in the combination of whole lung irradiation and high-dose chemotherapy for Ewing sarcoma patients with lung metastases: a review; [Risikostratifizierung der Lungentoxizität einer Kombination von Bestrahlung der gesamten Lunge und Hochdosischemotherapie bei Patienten mit Ewing-Sarkom und Lungenmetastasen – eine Übersicht]

被引：0

作者：

Scobioala S. ^{[1
]}

Eich H.T. ^{[1
]}

机构：

[1] Department of Radiotherapy and Radiooncology, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, Muenster

来源：

Strahlentherapie und Onkologie | 2020年 / 196卷 / 6期

关键词：

Chemotherapy; Ewing sarcoma; Lung metastases; Lung side effects; Radiotherapy;

D O I：

10.1007/s00066-020-01599-8

中图分类号：

学科分类号：

摘要：

Background: Whole lung irradiation (WLI) represents an important part of multimodal therapy in Ewing sarcoma (EwS) patients diagnosed with pulmonary metastases. This review discusses pulmonary toxicity in EwS patients with pulmonary metastases treated with WLI, who received different modes of high-dose chemotheray (HD-Cth). Methods: Literature was compiled using the Cochrane Library, PubMed database, and the National Institute of Health (NIH) clinical trials register. Relevant patient information, including nature of HD-Cth, acute and late lung toxicities, and pulmonary function disorders, was selected from the above databases. Results: Nine reports with a total of 227 patients, including 57 patients from a single randomized trial were included in this review. No acute or chronic symptomatic pulmonary toxicities were observed in patients that received WLI after HD busulfan-melphalan (HD-Bu/Mel), but 8% of these patients were diagnosed with asymptomatic restrictive lung disease. Grade 1 or 2 acute or chronic lung adverse effects were observed in up to 30% of patients that received WLI after HD treosulfan/Mel (HD-Treo/Mel) or HD etoposide (E)/Mel. Interstitial pneumonitis was present in 9% of patients treated concurrently with E/Mel and total body irradiation (TBI) with 8 Gy. Radiation doses as well as time between HD-Cth and WLI were both identified as significant risk factors for pulmonary function disorders. Conclusion: The risk of adverse lung effects after WLI depends on several factors, including cumulative radiation dose and dose per fraction, HD-Cth regimen, and time interval between HD-Cth and WLI. A cumulative radiation dose of up to 15 Gy and a time interval of at least 60 days can potentially lead to a reduced risk of pulmonary toxicities. No evident adverse lung effects were registered in patients that received simultaneous therapy with HD-Cth and TBI. However, pulmonary function testing and lung toxicity reports were lacking for most of these patients. © 2020, The Author(s).

引用

页码：495 / 504

页数：9

共 39 条

[1] Paulussen M., Ahrens S., Craft A.W., Dunst J., Frohlich B., Jabar S., Rube C., Winkelmann W., Wissing S., Zoubek A., Jurgens H., Ewing’s tumors with primary lung metastases: survival analysis of 114 (European Intergroup) Cooperative Ewing’s Sarcoma Studies patients, J Clin Oncol, 16, pp. 3044-3052, (1998)
[2] Bolling T., Schuck A., Paulussen M., Dirksen U., Ranft A., Konemann S., Dunst J., Willich N., Jurgens H., Whole lung irradiation in patients with exclusively pulmonary metastases of Ewing tumors. Toxicity analysis and treatment results of the EICESS-92 trial, Strahlenther Onkol, 184, pp. 193-197, (2008)
[3] Casey D.L., Alektiar K.M., Gerber N.K., Wolden S.L., Whole lung irradiation for adults with pulmonary metastases from Ewing sarcoma, Int J Radiat Oncol Biol Phys, 89, pp. 1069-1075, (2014)
[4] Schuck A., Ahrens S., Konarzewska A., Paulussen M., Frohlich B., Konemann S., Rube C., Rube C.E., Dunst J., Willich N., Jurgens H., Hemithorax irradiation for Ewing tumors of the chest wall, Int J Radiat Oncol Biol Phys, 54, pp. 830-838, (2002)
[5] Scobioala S., Ranft A., Wolters H., Jabar S., Paulussen M., Timmermann B., Juergens H., Hassenpflug W., Klingebiel T., Elsayad K., Eich H.T., Dirksen U., Impact of whole lung irradiation on survival outcome in patients with lung relapsed ewing sarcoma, Int J Radiat Oncol Biol Phys, 102, pp. 584-592, (2018)
[6] Dunst J., Paulussen M., Jurgens H., Lung irradiation for Ewing’s sarcoma with pulmonary metastases at diagnosis: results of the CESS-studies, Strahlenther Onkol, 169, pp. 621-6233, (1993)
[7] Paulussen M., Ahrens S., Burdach S., Craft A., Dockhorn-Dworniczak B., Dunst J., Frohlich B., Winkelmann W., Zoubek A., Jurgens H., Primary metastatic (stage IV) Ewing tumor: survival analysis of 171 patients from the EICESS studies. European Intergroup Cooperative Ewing Sarcoma Studies, Ann Oncol, 9, pp. 275-281, (1998)
[8] Whelan J.S., Burcombe R.J., Janinis J., Baldelli A.M., Cassoni A., A systematic review of the role of pulmonary irradiation in the management of primary bone tumours, Ann Oncol, 13, pp. 23-30, (2002)
[9] Indelicato D.J., Keole S.R., Lagmay J.P., Morris C.G., Gibbs C.P., Scarborough M.T., Islam S., Marcus R.B., Chest wall Ewing sarcoma family of tumors: long-term outcomes, Int J Radiat Oncol Biol Phys, 81, pp. 158-166, (2011)
[10] Moher D., Liberati A., Tetzlaff J., Altman D.G., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, J Clin Epidemiol, 62, pp. 1006-1012, (2009)

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