High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases : Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008

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High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases : Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008

Dirksen, Uta (författare): University Hospital Essen

Brennan, Bernadette (författare): Royal Manchester Children's Hospital

Le Deley, Marie Cécile (författare): Centre Oscar Lambret,University of Paris-Saclay

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Cozic, Nathalie (författare): Institut Gustave Roussy

van den Berg, Henk (författare): Emma Children’s Hospital,Academic Medical Center of University of Amsterdam (AMC)

Bhadri, Vivek (författare): Cancer Institute of New South Wales

Brichard, Bénédicte (författare): Saint-Luc University Hospital

Claude, Line (författare): Centre Léon Bérard

Craft, Alan (författare): University of Newcastle upon Tyne

Amler, Susanne (författare): University of Münster,Friedrich Loeffler Institute

Gaspar, Natalie (författare): Institut Gustave Roussy

Gelderblom, Hans (författare): Leiden University Medical Centre

Goldsby, Robert (författare): University of California, San Francisco,UCSF Benioff Children‘s Hospital

Gorlick, Richard (författare): University of Texas

Grier, Holcombe E. (författare): Boston Children's Hospital

Guinbretiere, Jean Marc (författare): Hôpital René-Huguenin

Hauser, Peter (författare): Semmelweis University

Hjorth, Lars (författare): Lund University,Lunds universitet,Sena effekter efter barncancerbehandling,Forskargrupper vid Lunds universitet,Late effects after childhood cancer treatment,Lund University Research Groups

Janeway, Katherine (författare): Boston Children's Hospital

Juergens, Heribert (författare): University Hospital Münster

Judson, Ian (författare): Royal Marsden NHS Foundation Trust

Krailo, Mark (författare): University of Southern California

Kruseova, Jarmila (författare): Charles University in Prague

Kuehne, Thomas (författare): University Children's Hospital, Basel

Ladenstein, Ruth (författare): Medical University of Vienna

Lervat, Cyril (författare): Centre Oscar Lambret

Lessnick, Stephen L. (författare): Ohio State University

Lewis, Ian (författare): University of Leeds

Linassier, Claude (författare): University Hospital of Tours

Marec-Berard, Perrine (författare): Pediatric Hematology and Oncology Institute (IHOPE)

Marina, Neyssa (författare): Five Prime Therapeutics Inc

Morland, Bruce (författare): Birmingham Children's Hospital

Pacquement, Hélène (författare): Curie Institute, Paris

Paulussen, Michael (författare): Witten/Herdecke University

Randall, R. Lor (författare): University of California, Davis

Ranft, Andreas (författare): Institut Gustave Roussy,University of Paris-Saclay

Le Teuff, Gwénaël (författare): University of Birmingham

Wheatley, Keith (författare): University College London Hospital

Whelan, Jeremy (författare): The Children's Hospital of Philadelphia,University of Pennsylvania

Womer, Richard (författare): Seattle Children’s Hospital

Oberlin, Odile (författare): Institut Gustave Roussy

Hawkins, Douglas S. (författare): Children's Hospital and Regional Medical Center, Seattle,Seattle Children’s Hospital

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(creator_code:org_t)

Euro-EW.I.N.G. 99 Investigators

2019
2019
Engelska 11 s.
Ingår i: Journal of Clinical Oncology. - 0732-183X. ; 37:34, s. 3192-3202

Relaterad länk:: http://dx.doi.org/10...; visa fler...; https://lup.lub.lu.s...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

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PURPOSE: The R2Pulm trial was conducted to evaluate the effect of busulfan-melphalan high-dose chemotherapy with autologous stem-cell rescue (BuMel) without whole-lung irradiation (WLI) on event-free survival (main end point) and overall survival, compared with standard chemotherapy with WLI in Ewing sarcoma (ES) presenting with pulmonary and/or pleural metastases. METHODS: From 2000 to 2015, we enrolled patients younger than 50 years of age with newly diagnosed ES and with only pulmonary or pleural metastases. Patients received chemotherapy with six courses of vincristine, ifosfamide, doxorubicin, and etoposide (VIDE) and one course of vincristine, dactinomycin, and ifosfamide (VAI) before either BuMel or seven courses of VAI and WLI (VAI plus WLI) by randomized assignment. The analysis was conducted as intention to treat. The estimates of the hazard ratio (HR), 95% CI, and P value were corrected for the three previous interim analyses by the inverse normal method. RESULTS: Of 543 potentially eligible patients, 287 were randomly assigned to VAI plus WLI (n = 143) or BuMel (n = 144). Selected patients requiring radiotherapy to an axial primary site were excluded from randomization to avoid excess organ toxicity from interaction between radiotherapy and busulfan. Median follow-up was 8.1 years. We did not observe any significant difference in survival outcomes between treatment groups. Event-free survival was 50.6% versus 56.6% at 3 years and 43.1% versus 52.9% at 8 years, for VAI plus WLI and BuMel patients, respectively, resulting in an HR of 0.79 (95% CI, 0.56 to 1.10; P = .16). For overall survival, the HR was 1.00 (95% CI, 0.70 to 1.44; P = .99). Four patients died as a result of BuMel-related toxicity, and none died after VAI plus WLI. Significantly more patients in the BuMel arm experienced severe acute toxicities than in the VAI plus WLI arm. CONCLUSION: In ES with pulmonary or pleural metastases, there is no clear benefit from BuMel compared with conventional VAI plus WLI.

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Av författaren/redakt...: Dirksen, Uta; Brennan, Bernade ...; Le Deley, Marie ...; Cozic, Nathalie; van den Berg, He ...; Bhadri, Vivek; visa fler...; Brichard, Bénédi ...; Claude, Line; Craft, Alan; Amler, Susanne; Gaspar, Natalie; Gelderblom, Hans; Goldsby, Robert; Gorlick, Richard; Grier, Holcombe ...; Guinbretiere, Je ...; Hauser, Peter; Hjorth, Lars; Janeway, Katheri ...; Juergens, Heribe ...; Judson, Ian; Krailo, Mark; Kruseova, Jarmil ...; Kuehne, Thomas; Ladenstein, Ruth; Lervat, Cyril; Lessnick, Stephe ...; Lewis, Ian; Linassier, Claud ...; Marec-Berard, Pe ...; Marina, Neyssa; Morland, Bruce; Pacquement, Hélè ...; Paulussen, Micha ...; Randall, R. Lor; Ranft, Andreas; Le Teuff, Gwénaë ...; Wheatley, Keith; Whelan, Jeremy; Womer, Richard; Oberlin, Odile; Hawkins, Douglas ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Pediatrik

Artiklar i publikationen: Journal of Clini ...

Av lärosätet: Lunds universitet

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High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases : Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008

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