Table 1.
Therapy-related toxicity outcome
| Author/year | HD-Ctx+ WLI (pts) |
Cumulative/ fraction dose (Gy) |
Boostd (pts/Gy) | Resection of lung lesions (pts) | Primary Ctx | HD-Ctx (mode/pts) | Interval between HD-Ctx and WLI (days) | Lung function disordera (severity/pts) | Acute lung toxicityb (pts/grade) |
Late lung toxicityb (pts/grade) | Other radiation-related toxicitiesc | Death related to therapy (pts) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Luksch/2012 [14] | 57 |
15/1.5 > 14y. 12/1.2 < 14y. |
n.a. | 6 | VAI_CE/VAC_IE | Bu/Mel (57) | 60–90 |
Mild: 1 Moderate: 2 Severe: 1 |
0 | 0 | 0 | 1 |
|
Paulussen/ 1998 [1] |
3 |
18/1.5 > 14y. 15/1.5 < 14y. |
n.a. | n.a. |
VACA or VAIA or EVAIA |
Bu/Mel (3) | n.a. | Severity n.a./7 | 1/1 | 1/1 | 1 | 2 |
| Scobioala/2018 [5] | 32 |
18/1.5 > 14y. 15/1.5 < 14y. |
9 (45) | 5 |
EVAIA or VIDE |
Treo/Mel (27) E/Mel (5) |
30–60 |
Mild: 5 Moderate: 3 Severe: 0 |
5/1 2/2 |
4/1 1/2 |
0 | 0 |
| Burdach/2003 [15] | 26 | 8/2 × 1.5/d.e | n.a. | 0 |
EVAIA or VIDE |
E/Mel (26) | Concurrently | n.a. | 2/2 | 0 | 2 | 6 |
| Pape/1999 [16] | 39 |
10/2 × 1.5/d.e, or 18/1.5 > 15y. 15/1.5 < 15y. |
n.a. | n.a. | EVAIA | E/Mel (39) |
Concurrently (17 pts) Sequentially (22 pts) |
n.a. | n.a. | n.a. | n.a. | 6 |
| Czyzewski/1999 [17] | 9 |
12/2 × 2/d.e (6 pat.) 15/1.5 (1 pt.) 12.8/2 × 1.6/d. (1 pt.) |
n.a. | 3 | n.a. | E/Mel (9) |
Concurrently (6 pts) Sequentially (3 pts) |
n.a. | 0 | 0 | n.a. | 1 |
| Miser/1988 [18] | 21 | 8/2 × 2/d.e | 2 (55–60) | 0 | n.a. | VADRIAC (21) | Concurrently | n.a. | 0 | 0 | n.a. | 0 |
| Burdach/1993 [19] | 17 | 8/2 × 1.5/d.e |
1 (30) 1 (50) |
4 |
VAIA or EVAIA |
E/Mel (17) | Concurrently | – | 2/2 | 1/3 | 0 | 1 |
| Meyers/2001 [20] | 23 | 8/2 × 2/d.e | – | – | VACA | E/Mel (23) | Concurrently | n.a. | 0 | 0 | 1 | 5 |
pt(s) Patient(s); WLI whole lung irradiation; Cth/HD-Ctx chemotherapy/high-dose chemotherapy; Gy gray; n.a. detailed information is not available from the report; Treo treosulphan; Mel melphalan; E etoposide; C cyclophosphamide; V vincristine; I. ifosfamide; A adriamycin; D doxorubicin
a Pulmonary function disorders were examined by pulmonary function testing
b Acute and late lung toxicities graded according to the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer toxicity criteria (15)
c Not pulmonary adverse effects: dysphagia, esophagitis, cardiac disorders, etc..
d Additional boost for primary chest wall Ewing sarcoma
e Consolidating therapy that includes total body irradiation and high-dose chemotherapy for primary metastatic or relapsed Ewing sarcoma patients