{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:10:35Z","timestamp":1784196635564,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Though\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG\u2010PET CT scan is established as a standard of care imaging technique for staging and restaging in Ewing Sarcoma (ES), its utility in the prognostic assessment of residual masses post definitive radiotherapy to the primary is still unknown. This study audits the above.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Children \u2264\u200915\u2009years of age with ES treated from January 2012 to December 2023 who received definitive radiotherapy to the primary and had an 18F\u2010FDG\u2010PET CT 3\u2009months post completion of RT (PET\u20103) were analyzed retrospectively. Disease status of the soft tissue component based on PET\u20103 was classified as having either no residual, anatomic residual with no FDG\u2010avidity, or FDG\u2010avid residual.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and forty\u2010nine patients formed the study cohort. Metastatic disease was present in 46.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200969). PET3 showed FDG\u2010avid residual in 17.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200926), anatomic residual in 30.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945), and no residual in 52.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200978) of patients. Five\u2010year EFS of those with no residual, anatomic residual, and FDG\u2010avid residual in the whole cohort were 52.8% (95% CI: 40.4%\u201365.2%), 45.9% (95% CI: 28.4%\u201363.4%), 42.6% (95% CI: 20.7%\u201364.6%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038). Among patients with FDG\u2010avid residual disease, 5\u2010year EFS was 22.9% (95% CI: 5.0%\u201345.2%) for metastatic cases compared to 75.0% (95% CI: 44.0%\u2013100%) for localized disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). A PET3 SUV\n                      <jats:sub>max<\/jats:sub>\n                      &gt;\u20093.9 was prognostic for EFS (HR\u20149.59, 95% CI: 3.94\u201323.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001) in the metastatic cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In patients with metastatic Ewing Sarcoma treated with definitive radiotherapy of the primary, the persistence of FDG\u2010avid residual on post\u2010treatment PET\/CT signifies a markedly poor prognosis. In particular, a PET3 SUV\n                      <jats:sub>max<\/jats:sub>\n                      exceeding 3.9 delineates an ultra\u2010high\u2010risk cohort.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72021","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:21:32Z","timestamp":1780730492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Fluorodeoxyglucose Uptake on Post\u2010Definitive Radiotherapy\n                    <scp>PET<\/scp>\n                    \/\n                    <scp>CT<\/scp>\n                    Evaluation Predicts Poor Survival in Pediatric Metastatic Ewing Sarcoma: A Single\u2010Center Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-2058","authenticated-orcid":false,"given":"Badira Cheriyalinkal","family":"Parambil","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilendu","family":"Purandare","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-7987","authenticated-orcid":false,"given":"Maya","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkata Rama Mohan","family":"Gollamudi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha","family":"Laskar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jifmi Jose","family":"Manjali","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Janu","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasundhara","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Baheti","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukta","family":"Ramadwar","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Panjwani","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat","family":"Rekhi","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhanupriya","family":"Sandupatla","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeswari","family":"Arul","sequence":"additional","affiliation":[{"name":"Clinical Research Secretariat Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2581-3086","authenticated-orcid":false,"given":"Venkatesh","family":"Rangarajan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Chinnaswamy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI)  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/0100\u20103984.2013.1887"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.109076"},{"key":"e_1_2_12_4_1","unstructured":"NCCN \u201cbone.pdf \u201d(2025) https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/bone.pdf."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010016\u20103509\u2010z"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000013457"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.20077"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.01.077"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002565"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28604"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.07.1766"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29989"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2023.101269"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30617\u20105"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.72021","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:02:22Z","timestamp":1784196142000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.72021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/cam4.72021"],"URL":"https:\/\/doi.org\/10.1002\/cam4.72021","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72021"}}