1455P - Outcome of adolescents and young adults versus patients>30 years with Ewing sarcoma family tumors (EFT): Update on a retrospective single-center ex...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cancer in Adolescents
Bone Sarcomas
Cancer in Young Adults
Presenter Wolfgang Lamm
Citation Annals of Oncology (2014) 25 (suppl_4): iv494-iv510. 10.1093/annonc/mdu354
Authors W. Lamm1, G. Amann2, M. Bojic3, T. Brodowicz4, K. Dieckmann5, P. Funovics6, W. Klepetko7, I. Nöbauer8, S. Schur4, W. Köstler4
  • 1Oncology, Medical University of Vienna, 1090 - Vienna/AT
  • 2Pathology, Medical University of Vienna, Vienna/AT
  • 3Oncology, Medical university of Vienna, Vienna/AT
  • 4Oncology, Medical University of Vienna, Vienna/AT
  • 5Radiation Oncology, Medical University of Vienna, Vienna/AT
  • 6Orthopedics, University of Vienna, Vienna/AT
  • 7Thoracic Surgery, Medical University of Vienna, Vienna/AT
  • 8Radiology, Medical University of Vienna, Vienna/AT

Abstract

Aim

EFT incidence peaks in adolescence and patients >14-18 years (a) are often reported to have a worse prognosis. Little is known about the treatment and outcome of older adult patients as most randomized trials excluded patients >30-40a.

Methods

Retrospective analysis of 41 consecutive adult EFT patients (pats; Ewing sarcoma: 35, PNET: 6) treated at our department since 2000, comparing 20 (49%) patients aged <30a (median [range]: 21 [5-27]), with 21 (51%) ≥30a (median [range]: 42 [30-66]).

Results

In pats with localized EFT (13/30 <30a vs 17/30 >30a), disease characteristics (stage, tumor location/volume, laboratory abnormalities, performance status), chemotherapy (CT; incl. type and dose-intensity), radiologic and histologic response were similar in both age groups. Pats <30a were more likely to receive radiotherapy (p=0.065). Adjuvant high-dose CT with autologous peripheral blood stem cell transplantation (HD-CT->PBSCT; p=0.400) were similar in both groups. Median (95% confidence interval) progression free survival (PFS) was 37.9 (21.7-54.2) months for pats <30a vs 38.8 (14.1-63.4) months for pats ≥30a (p=0.708). Median overall survival (OS) was 83.2 (5.2-115.2) moths for pats <30a and vs 40.9 months for pats ≥30a (p=0.731). In pats presenting with metastatic EFT (<30a: 7, >30a: 4), disease and patient characteristics, first line CT dose-intensity and treatment response were similar between the two age groups. Younger pats received more local treatment to the primary tumor (surgery: p=0.819, radiotherapy p=0.006). PFS was 14.4 (0-30.8) months for pats <30a vs 8.7 (1.7-15.7) months for pats ≥30a (p=0.67). Median OS was 46.0 vs 10.0 months (p=0.434). Twenty pats (<30a: 10, >30a: 10) were treated for relapsed/refractory disease. Disease and pats characteristics were similar as were first-line CT (incl. dose intensity) and response. More patients≥30a died during/after first line therapy (4 vs 0).

Conclusions

Despite similar clinical presentation, CT tolerance and response, pats >30a with EFT have the same outcome compared to younger adults. OS was longer for pats <30a, but not statistically significant.

Disclosure

All authors have declared no conflicts of interest.