Radiation for bone metastases in Ewing sarcoma and rhabdomyosarcoma

Dana L. Casey, Leonard H. Wexler, Paul A. Meyers, Heather Magnan, Alexander J. Chou, Suzanne L. Wolden

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background: The role, optimal dose, and efficacy of radiotherapy (RT) for the treatment of bone metastases in rhabdomyosarcoma (RMS) and Ewing sarcoma (ES) are unclear. Procedure: All patients with ES or RMS who received RT for bone metastases with curative intent during frontline therapy at Memorial Sloan Kettering Cancer Center (MSKCC) between 1995 and 2013 were reviewed. Among the 30 patients (8 RMS and 22 ES), 49 bone metastases were irradiated. Results: Median biologically effective dose (BED) was 42.4Gy (range, 34.9-59.7) for RMS and 50.7Gy (range, 31.3-65.8) for ES. Tumor recurrence occurred in six of 49 irradiated bone metastases. Cumulative incidence of local failure at a treated metastatic site was 6.6% at 1 year and 9.0% at 3 years. Dose, fractionation, and RT technique did not impact local control at an irradiated site. The presence of >5 bone metastases was associated with worse local control at an irradiated site (P=0.07). The 3-year EFS was 33% in RMS and 16% in ES. Conclusions: RT appears to be an effective modality of local control for bone metastases in ES and RMS. Local control at sites of metastatic bone irradiation is similar to local control at the primary site after definitive RT. Doses in the biologic range prescribed for the definitive treatment of primary disease should be used for metastatic sites of disease.

Original languageEnglish (US)
Pages (from-to)445-449
Number of pages5
JournalPediatric Blood and Cancer
Issue number3
StatePublished - Mar 1 2015
Externally publishedYes


  • Ewing sarcoma
  • Radiation oncology
  • Rhabdomyosarcoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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