Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis.

Mateusz Jacek Spałek,Monika Dudzisz-Śledź,Jan Poleszczuk,Aleksandra Napieralska,Tomasz Skóra,Aleksandra Sztuder,Marzanna Chojnacka,Bartłomiej Tomasik,Piotr Rutkowski,Anna Małgorzata Czarnecka,Agata Szulc,Anna Raciborska,Bożena Cybulska-Stopa,Tomasz Winiecki,Jacek Fijuth,Jacek Matysiakiewicz,Adam Maciejczyk,Joanna Kaźmierska

doi:10.3390/cells10020366

Abstract

Background: Due to the rarity of osteosarcoma and limited indications for radiotherapy (RT), data on RT for this tumor are scarce. This study aimed to investigate the utilization of RT for osteosarcomas in the recent 20 years and to identify factors related to patients’ response to radiation. Methods: We performed a retrospective analysis of patients irradiated for osteosarcoma treatment. We planned to assess differences in the utilization of RT between the periods of 2000–2010 and 2011–2020, identify the risk factors associated with local progression (LP), determine whether RT-related parameters are associated with LP, and calculate patients’ survival. Results: A total of 126 patients with osteosarcoma who received 181 RT treatments were identified. We found a difference in RT techniques between RT performed in the years 2000–2010 and that performed in the years 2011–2020. LP was observed after 37 (20.4%) RT treatments. Intent of RT, distant metastases, and concomitant systemic treatment affected the risk of LP. Five-year overall survival was 33% (95% confidence interval (26%–43%)). Conclusions: RT for osteosarcoma treatment has evolved from simple two-dimensional palliative irradiation into more conformal RT applied for new indications including oligometastatic and oligoprogressive disease. RT may be a valuable treatment modality for selected patients with osteosarcoma.

Highlights

IntroductionOsteosarcoma, a rare primary bone tumor, mostly affects children and young adults
Osteosarcoma, a rare primary bone tumor, mostly affects children and young adults.It requires a multidisciplinary management
In the univariate analysis of factors related to the first RT, we found an influence of the palliative intent of RT on the hazard ratios (HR) of in-field local progression (Figure 1)

Summary

Introduction

Osteosarcoma, a rare primary bone tumor, mostly affects children and young adults. The standard treatment of localized disease consists of surgery with perioperative multiagent chemotherapy [1,2]. As with other cancers, irradiation could help palliate symptoms related to primary tumor or distant metastases. This study aimed to investigate the utilization of RT for osteosarcomas in the recent 20 years and to identify factors related to patients’ response to radiation. We planned to assess differences in the utilization of RT between the periods of 2000–2010 and 2011–2020, identify the risk factors associated with local progression (LP), determine whether. Intent of RT, distant metastases, and concomitant systemic treatment affected the risk of LP.

Objectives

Methods

Discussion

Conclusion