2002 CTOS Annual Meeting Posters — Radiation Oncology

EXTERNAL BEAM RADIATION IS AN EFFECTIVE ADJUVANT THERAPY FOR CLEAR CELL SARCOMA
[Abstract ID: 45]

Category: Radiation Oncology

Authors: James Hayden², David Zurakowski³, Thomas Delaney¹, Francis Hornicek¹, Henry Mankin¹, Mark Gebhardt¹

Author Institutions: ¹Massachusetts General Hospital, Massachusetts, United States; ²Oregon Health and Sciences University, Oregon, United States; ³The Childrens Hospital Boston, MA, United States

Presenter: James Hayden
haydenjam@hotmail.com

Correspondent: James Hayden
haydenjam@hotmail.com
Belmont MA United States 02478
Ph: 617-724-3700
Fax: 617-726-6823

Objectives: Clear cell sarcoma (CCS) is a rare soft tissue sarcoma. We sought to determine prognostic indicators and effective treatment methods.

Methods: We completed a retrospective review of the Massachusetts General Hospital and Children’s Hospital, Boston, records identifying 21 patients. We completed a systematic review of the English literature identifying 283 patients with clinical data from 83 articles. The cumulative database was used to evaluate patient demographics, prognositic factors, and the effect of external beam radiation.

Results: Common locations were foot/ankle, 38.7 percent, knee, 12.4 percent, and wrist/hand, 12.4 percent. Common metastatic sites were lymph nodes and the lung. Overall 5 year survival was 48.6 percent. Metastasis at presentation was a prognostic indicator with 5 year survival of 13 percent vs 55 percent (p <0.0001). Tumor size less than 5 cm was prognostic with 5 year survival rates of 30 percent vs 67 percent (p < 0.0001). 15 patients received external beam radiation for their primary tumor. All 15 had a surgical resection, were metastasis free at diagnosis, and did not receive chemotherapy. These patients received an average of 59.9 Gy. A control group of 100 patients with no radiation therapy but similar demographics (age, tumor size, primary tumor, and metastatic free at diagnosis) and treatment (surgical resection without chemotherapy) was identified. Fewer patients treated with radiation developed metastasis (13 vs 43 % p < 0.05) or died from disease (13 vs 43 % p< 0.05).

Conclusions: CCS tends to occur in young adults, in distal locations and metastasize to lymph nodes and lung. Tumor size equal or greater than 5 cm and and metastasis at diagnosis are poor prognositic indicators. External beam radiation is an effective adjuvant for primary CCS therapy.