Leg function after radiotherapy for Ewing's sarcoma

Abstract

Twenty-nine patients with Ewing's sarcoma of the lower extremity who survived for two or more years following therapy (5000 rad locally and systemic chemotherapy) were studied to assess functional status of the affected leg. Twenty-two of twenty-nine were alive and were reexamined; the deceased patients were evaluated by record review. Twenty-two of the twenty-nine had serial radiographs, which were reviewed to assess growth change induced by radiation. The living patients were divided on the basis of clinical examination into four functional groups with Group I comprising patients with minor functional limitations and leg length discrepancy 1.5 cm or less. Group II patients had moderate functional limitations with 2.5-cm leg-length discrepancy or less. Group III patients had severe functional limitations with up to 4-cm leg length discrepancy. Group IV patients had severe complications, sufficient enough to warrant amputation. Thirteen of twenty-two patients were classified as functional Group I, five as Group II, three as Group III, and one as Group IV. Radiographic changes in growing bone did not correlate with functional results. Although a femoral fracture and an age less than 16 years at diagnosis were found to be less favorable prognostic factors for the functional treatment result, these results show that neither femoral location nor young age justify primary amputation for Ewing's sarcoma of the lower leg extremity.

Early Radiation Effects on Tongue Function for Patients with Nasopharyngeal Carcinoma: A Preliminary Study

“…These changes may affect muscle cell function and consequently affect muscle contraction force [7,8]. During radiation therapy NPC patients often use a nasogastric tube for feeding to relieve the pain of mucosal ulcers, and the presence of that tube may decrease the backward tongue movement.…”

Ewing's sarcoma of the pelvis

“…In our series the functional results were the same in patients treated with local resection compared to those treated with radiotherapy alone, emphasising that deficits such as fibrosis and leg length discrepancy can be considerable after radiotherapy [8,10]. Major complications such as infection, skin necrosis or nerve palsies are seen after pelvic resections.…”

“…Nevertheless, certain factors, such as large size [8,9] and pelvic lesions [2, 5, 6, 14, 15, 17, 181, …”

Late effects of radiotherapy for pediatric extremity sarcomas

“…irradiated bone 9 months to 22.2 years after RT. This is consistent with the findings of Jentzsch et al, who found a 44% incidence of fractures in the irradiated femur of Ewing's sarcoma patients (4). Fractures may be secondary to a large biopsy site and impaired healing by RT (12).…”