{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:09:53Z","timestamp":1769605793493,"version":"3.49.0"},"reference-count":22,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Forschungsgemeinschaft"},{"name":"Heidelberg University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: To report dosimetric characteristics and early clinical outcomes in patients with pelvic Ewing sarcoma undergoing particle therapy. Methods: Patients \u2265 18 years old with pelvic Ewing sarcoma treated in adjuvant or definitive settings were considered for this retrospective analysis. Proton therapy was carried out with 45\u201360 Gy (RBE) (1.5\u20132 Gy (RBE) per fraction) and carbon ion therapy for recurrent disease with 51 Gy (RBE) (3 Gy (RBE) per fraction). Local control (LC), disease control (DC) and overall survival (OS) were calculated using the Kaplan\u2013Meier method. Results: For our sample, 21 patients were available, 18 of whom were treated for primary, 3 for locally recurrent and 16 for inoperable disease. The median CTV and PTV were 1215 cm3 and 1630 cm3. Median Dmean values for the PTV, bladder and rectum and median V40 Gy for the bowel for patients undergoing proton therapy were 56 Gy (RBE), 0.6 Gy (RBE), 9 Gy (RBE) and 15 cm3, respectively. At the end of particle therapy, G 1\u20132 skin reactions (n = 16\/21) and fatigue (n = 9\/21) were the main reported symptoms. After a median follow-up of 21 months, the 2-year LC, DC and OS were 76%, 56% and 86%, respectively. Conclusions: Particle therapy in adult pelvic Ewing sarcoma is feasible and provides excellent dosimetric results. First clinical outcomes are promising; however, further long-term follow-up is needed.<\/jats:p>","DOI":"10.3390\/cancers14246045","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T03:23:49Z","timestamp":1670556229000},"page":"6045","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Particle Therapy in Adult Patients with Pelvic Ewing Sarcoma\u2014Tumor and Treatment Characteristics and Early Clinical Outcomes"],"prefix":"10.3390","volume":"14","author":[{"given":"Maximilian P.","family":"Schmid","sequence":"first","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1195-7150","authenticated-orcid":false,"given":"Semi","family":"Harrabi","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Herfarth","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d8yvind S.","family":"Bruland","sequence":"additional","affiliation":[{"name":"Institute for Clinical Medicine, University of Oslo and Department of Oncology, Oslo University Hospital\u2014Norwegian Radium Hospital, 4950 Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9960-3052","authenticated-orcid":false,"given":"Thomas","family":"Welzel","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Haberer","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Ellerbrock","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Uhl","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Seidensaal","sequence":"additional","affiliation":[{"name":"Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1634\/theoncologist.11-5-503","article-title":"Ewing\u2019s sarcoma family of tumors: Current management","volume":"11","author":"Bernstein","year":"2006","journal-title":"Oncologist"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00066-020-01599-8","article-title":"Risk stratification of pulmonary toxicities in the combination of whole lung irradiation and high-dose chemotherapy for Ewing sarcoma patients with lung metastases: A review","volume":"196","author":"Scobioala","year":"2020","journal-title":"Strahlenther. Onkol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s00066-019-01460-7","article-title":"Considative mediastinal irradiation of malignant lymphoma using active scanning proton beams: Clinical outcome and dosimetric comparison","volume":"195","author":"Bougatf","year":"2019","journal-title":"Strahlenther. Onkol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1001\/jamaoncol.2019.4889","article-title":"Comparative Effectiveness of Proton vs Photon Therapy as Part of Concurrent Chemoradiotherapy for Locally Advanced Cancer","volume":"6","author":"Baumann","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/PPO.0b013e3181b01935","article-title":"Comparison of Carbon Ions Versus Protons","volume":"15","author":"Weber","year":"2009","journal-title":"Cancer J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/PPO.0000000000000078","article-title":"Comparing the Use of Protons and Carbon Ions for Treatment","volume":"20","author":"Uhl","year":"2014","journal-title":"Cancer J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/0168-9002(93)91335-K","article-title":"Magnetic scanning system for heavy ion therapy","volume":"330","author":"Haberer","year":"1993","journal-title":"NIM A"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2106\/JBJS.O.00362","article-title":"Improved prognosis for patients with Ewing sarcoma in the sacrum compared with the innominate bones: The Scandinavian Sarcoma Group experience","volume":"98","author":"Hesla","year":"2016","journal-title":"J. Bone Joint. Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ijrobp.2007.12.014","article-title":"Impact of local man-agement on long-term outcomes in Ewing tumors of the pelvis and sacral bones: The University of Florida experience","volume":"72","author":"Indelicato","year":"2008","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/CORR.0000000000000962","article-title":"Which Factors Are Associated with Local Control and Survival of Patients with Lo-calized Pelvic Ewing\u2019s Sarcoma? A Retrospective Analysis of Data from the Euro-EWING99 Trial","volume":"478","author":"Andreou","year":"2020","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.ijrobp.2020.04.043","article-title":"Treatment Outcomes After Proton Therapy for Ewing Sarcoma of the Pelvis","volume":"107","author":"Uezono","year":"2020","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.suronc.2018.07.016","article-title":"Prognostic factors for survival in Ewing sarcoma: A systematic review","volume":"27","author":"Bosma","year":"2018","journal-title":"Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"26540","DOI":"10.1002\/pbc.26504","article-title":"Pelvis Ewing sarcoma: Local control and survival in the modern era","volume":"64","author":"Ahmed","year":"2017","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s00066-012-0304-z","article-title":"Pelvic Ewing sarcomas. Three-dimensional conformal vs. intensity-modulated radiotherapy","volume":"189","author":"Mounessi","year":"2013","journal-title":"Strahlenther. Onkol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ctrv.2015.12.007","article-title":"Proton beams in cancer treatments: Clinical outcomes and dosi-metric comparisons with photon therapy","volume":"43","author":"Doyen","year":"2016","journal-title":"Cancer Treat. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.clon.2010.01.005","article-title":"Intensity-modulated radiotherapy allows escalation of the radiation dose to the pelvic lymph nodes in patients with locally advanced prostate cancer: Preliminary results of a phase I dose escalation study","volume":"22","author":"Khoo","year":"2010","journal-title":"Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.ijrobp.2013.11.214","article-title":"Predictors of Grade 3 or Higher Late Bowel Toxicity in Patients Undergoing Pelvic Radiation for Cervical Cancer: Results From a Prospective Study","volume":"88","author":"Chopra","year":"2014","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.radonc.2018.03.009","article-title":"Fatigue, insomnia and hot flashes after definitive radiochemotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: An analysis from the EMBRACE study","volume":"127","author":"Smet","year":"2018","journal-title":"Radiother. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.ijrobp.2021.11.022","article-title":"Risk factors for persistent late fatigue after radiochemotherapy in cervical cancer (EM-BRACE study)","volume":"112","author":"Smet","year":"2022","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/pbc.20904","article-title":"Dose response and local control using radiotherapy in non-metastatic Ewing sarcoma","volume":"49","author":"Paulino","year":"2007","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.ijrobp.2022.04.024","article-title":"Radiation Therapy Dose Escalation in Unresectable Ewing Sarcoma: Final Results of a Phase 3 Randomized Controlled Trial","volume":"113","author":"Laskar","year":"2022","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3838","DOI":"10.1200\/JCO.2006.05.9188","article-title":"Local control in pelvic Ewing sarcoma: Analysis from INT-0091\u2014A report from the Children\u2019s On-cology Group","volume":"24","author":"Yock","year":"2006","journal-title":"J. Clin. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6045\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:36:28Z","timestamp":1760146588000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,8]]},"references-count":22,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14246045"],"URL":"https:\/\/doi.org\/10.3390\/cancers14246045","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,8]]}}}