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Radiation treatment of Ewing's sarcoma

General

Patients with Ewing's sarcoma are given postoperative radiation treatment for marginal or intralesional surgical margins. Radiation therapy may also be administered without previous surgery. Treatment is given in combination with chemotherapy.

The total treatment time for Ewing's sarcoma is 30-40 weeks and radiation treatment is given in week 14-17 for postoperative radiation treatment and in week 13-16 for inoperable tumors.

For metastases, radiation treatment is given for symptom relief. Total lung irradiation is administered 10 weeks after end of chemotherapy.

Many patients are children and the indication for radiation treatment must be determined by a risk/benefit analysis.

Indications

Ewing's sarcoma with:
  • operable tumor
    • after marginal surgery and not complete histological response
    • after intralesional surgery
  • inoperable tumor
    • after chemotherapy
  • metastatic disease
    • for inoperable bone metastasis
    • lung metastasis
    • pain relief from bone metastases

Goal

  • Cure the disease
  • Palliation

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