Primary refractory Ewing sarcoma of the chest wall in an adult patient (case report). The potential and role of radiation therapy

Ewing sarcoma is the second most common bone tumor, behind osteosarcoma, and is the most common bone tumor among children under 15 years of age. Quite rarely, these tumors occur in patients over 30 years of age and under 5 years of age. Ewing sarcoma of the chest wall is a rare malignant neoplasm, which is rarely reported in the scientific literature. An integrated approach combining chemotherapy, surgery, and radiation therapy is commonly used in the treatment of this neoplasm. However, there is no standard treatment for this tumor when the disease progresses during the first-line treatment. Although modern combined approaches to treatment, including chemotherapy, surgery, and radiation therapy, help achieve disease control in some patients, the lack of standardized protocols for the treatment of refractory and recurrent forms results in significant difficulties in determining optimal therapeutic options. In real-world clinical practice, physicians have limited personal experience in managing such patients, which leads to variability in the chosen treatment plans for refractory disease and the need to make decisions based on limited data. The article discusses the main approaches to the treatment, as well as the potential and role of radiation therapy in the treatment of this disease and presents a case report of unresectable Ewing sarcoma of the chest wall in a 50-year-old male patient with local progression during first-line chemotherapy.