Leg function after radiotherapy for Ewing's sarcoma

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Abstract
Patients (29) with Ewing''s sarcoma of the lower extremity who survived for 2 or more years following therapy (5000 rad locally and systemic chemotherapy) were studied to assess functional status of the affected leg. Twenty-two of 29 were alive and were reexamined; the deceased patients were evaluated by record review. Twenty-two of the 29 had serial radiographs, which were reviewed to assess growth change induced by radiation. The living patients were divided on the basis of clinical examination into 4 functional groups with group 1 comprising patients with minor functional limitations and leg length discrepancy 1.5 cm or less. Group 2 patients had moderate functional limitations with 2.5 cm leg-length discrepancy or less. Group 3 patients had severe functional limitations with up to 4 cm leg length discrepancy. Group 4 patients had severe complications, sufficient enough to warrant amputation. Of 22 patients, 13 were classified as functional group 1, 5 as group 2, 3 as group 3 and 1 as group 4. Radiographic changes in growing bone did not correlate with functional results. A femoral fracture and an age less than 16 yr at diagnosis were less favorable prognostic factors for the functional treatment result, but neither femoral location nor young age justify primary amputation for Ewing''s sarcoma of the lower leg extremity.