Table 5.

Radiotherapy dose and fractionation for ewing sarcoma

Setting	Dosage
Pre-operative radiotherapy	The total dose for preoperative irradiation is 50.4 Gy in 28 fractions in a single phase to the PTV. If there are concerns about organ tolerance or wound healing, then this dose can be reduced to 45 Gy in 25 Gy fractions
Post-operative radiotherapy	The total dose for postoperative radiotherapy is 54 Gy in 30 fractions, delivered as 45 Gy in 25 fractions to PTV1, and 9 Gy in 5 fractions to PTV2
Definitive radiotherapy	The total dose for definitive radiotherapy is 54 Gy in 1.8 Gy fractions, delivered as a single phase. A boost of 5.4 Gy in 3 fractions may be considered if desired, keeping within standard normal tissue dose constraints

Fractionation: conventionally fractionated radiotherapy (once daily fractions, five 1.8 Gy fractions per week) is the preferred fractionation schedule. In very young children, fractionation using 1.6 Gy fractions may be considered

Taken from: Euro–Ewing-2012 radiotherapy guidelines [158]