High-Intensity Focused Ultrasound (HIFU) for the Treatment of Pediatric Ewing Sarcoma: A SingleCenter Retrospective Study
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i2.5326
Abstract
Purpose: To evaluate the safety, clinical outcomes, and advantages of HIFU as a non-invasive local therapy for Ewing sarcoma in children and adolescents, especially for limb-salvage in patients with extensive bone destruction or unresectable lesions. Methods: A retrospective review was conducted of all pediatric patients with pathologically confirmed Ewing sarcoma treated with HIFU at a single tertiary children’s hospital between January 2010 and June 2023. Clinical data, imaging features, treatment protocols, complications, and survival outcomes were analyzed. Results: Seven patients were enrolled, including 3 males and 4 females, with a median age of 7.4 years (range 3.7–17.0 years). Four patients had localized disease, and three had widespread metastatic lesions at initial diagnosis. All four localized patients had extensive bone invasion that precluded limb-salvage resection. HIFU combined with chemotherapy achieved complete local tumor ablation in 2 patients, and all four localized patients remained alive at the final follow-up. Among the three metastatic patients, HIFU significantly reduced tumor burden, relieved pain, and improved quality of life, although all eventually died of systemic progression. Conclusion: HIFU is a safe, effective, and non-invasive local treatment for pediatric Ewing sarcoma. It serves as a valuable limb-salvage modality for localized patients with extensive bone destruction. For metastatic patients, HIFU provides effective palliation with minimal trauma and may be used as part of multidisciplinary comprehensive therapy.
Keywords
pediatric Ewing sarcoma; HIFU; high-intensity focused ultrasound; limbsalvage; non-invasive ablation; pediatric bone tumor
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[3] Wang Y, Dong H. Advances in the treatment of Ewing sarcoma family of tumors. J Clin Pediatr Surg. 2022;21(2):191-195.
[4] Zhu J, Zhu H, Mei Z, et al. High-intensity focused ultrasound ablation: an effective and safe treatment for secondary hypersplenism. Br J Radiol. 2014;87(1043):20140374.
[5] Rodriguez-Galindo C, Navid F, Liu T, et al. Prognostic factors for local and distant control in Ewing sarcoma family of tumors. Ann Oncol. 2008;19(4):814-820.
[6] Balamuth NJ, Womer RB. Ewing's sarcoma. Lancet Oncol. 2010;11(2):184-192.
[7] Tural D, Molinas Mandel N, Dervisoglu S, et al. Extraskeletal Ewing's sarcoma family of tumors in adults: prognostic factors and clinical outcome. Jpn J Clin Oncol. 2012;42(5):420-426.
[8] Rowe RG, Thomas DG, Schuetze SM, et al. Ewing sarcoma of the kidney: case series and literature review of an often overlooked entity. Urology. 2013;81(2):347-353.
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[12] Wang Y, Wang W, Tang J. Primary malignant tumours of the bony pelvis: US-guided high-intensity focused ultrasound ablation. Int J Hyperthermia. 2013;29(7):683-687.
[13] Yu W, Tang L, Lin F, et al. High-intensity focused ultrasound: noninvasive treatment for local unresectable recurrence of osteosarcoma. Surg Oncol. 2015;24(1):9-15.
[14] Chen W, Zhu H, Zhang L, et al. Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation. Radiology. 2010;255(3):967-978.
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