Chest wall resection for ewing's sarcoma of the rib: an unnecessary procedure

Prognostic Factors and Outcome in Askin-Rosai Tumor: A Review of 104 Patients

“…Few studies have reported late radiotherapy sequelae like restrictive pulmonary disease, hypoplasia of chest, and scoliosis (18,19). In our present study 19% patients experienced late radiation sequelae.…”

Chest wall reconstruction using implantable cross-linked porcine dermal collagen matrix (Permacol)

“…Over the last decade, however, the advances in multimodal therapy regimens have limited the need for aggressive postoperative radiation while concurrently improving long-term survival rates [12,13]. A recent series looking at 353 patients with Ewing sarcoma/PNET, including 53 patients with primary chest wall tumors, showed 5-year event-free survival of 68% in the patients treated with contemporary neoadjuvant regimens [12].…”

Chest Wall Ewing Sarcoma Family of Tumors: Long-Term Outcomes

“…Recently, however, authors have advocated avoiding RT when possible (3,22,23). This is an understandable concern, given the documented incidence of second malignancy (24), cardiotoxicity (2,25), constrictive pericarditis (26), chest wall muscle atrophy (25), scoliosis (27), pnuemonitis (2), and decreased lung volume, compliance, and diffusing capacity (26,27) attributed to radiation. Furthermore, common chemotherapy regimens including actinomycin D, adriamycin, and high-dose cyclophosphamide have a radiosensitizing effect on normal structures (24), and the tissue of young children may be particularly susceptible to pulmonary toxicity (28).…”

“…Smaller tumors are more likely to be completely resected (2). In the modern era, neoadjuvant chemomotherapy frequently downsizes tumors and therefore permits resection with less morbidity (17,26). Similar reasoning suggests that preoperative RT would provide an additive benefit for locally advanced tumors by decreasing the extent of surgery and increasing the likelihood of a complete resection; however, the outcome data after this approach is extremely limited (5,24).…”