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@ARTICLE{Heesen:278645,
      author       = {P. Heesen and A. Ranft and V. Bhadri and B. Brichard and S.
                      Collaud and S. Cyprova and H. Eich and T. Ek and H.
                      Gelderblom and J. Hardes and L. Haveman and S. Jabar and W.
                      Hartmann and D. Andreou and P. Hauser and J. Kersting and H.
                      Juergens and J. Kanerva and T. Kühne and A. Raciborska and
                      J. Rascon and A. Streitbürger and B. Timmermann$^*$ and Y.
                      Uhlenbruch and U. Dirksen},
      title        = {{A}ssociation between local treatment modalities and
                      event-free survival, overall survival, and local recurrence
                      in patients with localised {E}wing {S}arcoma. {R}eport from
                      the {E}wing 2008 trial.},
      journal      = {European journal of cancer},
      volume       = {192},
      issn         = {0014-2964},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-01689},
      pages        = {113260},
      year         = {2023},
      abstract     = {Local treatment is a crucial element in the standard of
                      care for Ewing sarcoma (EWS). While systemic treatment is
                      improved in randomised clinical trials, local treatment
                      modalities are discussed controversially. We analysed the
                      association between local therapy and event-free survival
                      (EFS), overall survival (OS), and local recurrence (LR) in
                      prospectively collected data of patients with localised
                      EWS.We analysed data from the international Ewing 2008 study
                      registered between 2009 and 2019 in 117 centres. After
                      induction chemotherapy, patients received surgery,
                      radiotherapy, or a combination thereof. We performed Cox
                      regression, conducted propensity score-weighted sensitivity
                      analysis, and performed subgroup analyses. Hazard ratios
                      (HRs) and $95\%$ confidence intervals are reported.We
                      included 863 patients with localised EWS (surgery alone:
                      331, combination therapy: 358, definitive radiotherapy:
                      174). In patients treated with combination therapy compared
                      to surgery alone, EFS HR was 0.84 (0.57-1.24; p = 0.38), OS
                      HR was 0.84 (0.57-1.23; p = 0.41), and LR HR was 0.58
                      (0.26-1.31; p = 0.19). Hazards of any event were increased
                      in patients treated with definitive radiotherapy compared to
                      surgery only, HR 1.53 (1.02-2.31; p = 0.04). Patients with
                      poor responses to chemotherapy benefitted from combination
                      therapy over definitive surgery with an EFS HR 0.49
                      (0.27-0.89; p = 0.02). Patients with pelvic tumours
                      benefitted from combination therapy over surgery only
                      regarding LR, HR 0.12 (0.02-0.72; p = 0.02).Patients with
                      poor responses to chemotherapy benefitted from radiotherapy
                      added to surgery. In the whole group, radiotherapy alone as
                      opposed to surgery alone increased the hazards of any
                      event.},
      keywords     = {Bone tumour (Other) / Ewing sarcoma (Other) / Local therapy
                      (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37595489},
      doi          = {10.1016/j.ejca.2023.113260},
      url          = {https://inrepo02.dkfz.de/record/278645},
}