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Tumour volume reduc...
Tumour volume reduction after neoadjuvant chemotherapy impacts outcome in localised embryonal rhabdomyosarcoma
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- Dantonello, Tobias M (author)
- Paediatrics 5 (oncology, hematology, immunology), Olgahospital Klinikum Stuttgart, Germany
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- Stark, Monika (author)
- Paediatrics 5 (oncology, hematology, immunology), Olgahospital Klinikum Stuttgart, Germany
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Timmermann, Beate (author)
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Fuchs, Jörg (author)
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Selle, Barbara (author)
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Linderkamp, Christin (author)
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Handgretinger, Rupert (author)
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Hagen, Rudolf (author)
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Feuchtgruber, Simone (author)
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Kube, Stefanie (author)
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Kosztyla, Daniel (author)
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Kazanowska, Bernarda (author)
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Ladenstein, Ruth (author)
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Niggli, Felix (author)
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- Ljungman, Gustaf, 1958- (author)
- Uppsala universitet,Pediatrik,Barnonkologisk forskning/Ljungman
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Bielack, Stefan S (author)
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Klingebiel, Thomas (author)
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- Koscielniak, Ewa (author)
- Paediatrics 5 (oncology, hematology, immunology), Olgahospital Klinikum Stuttgart, Germany
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(creator_code:org_t)
- 2014-09-27
- 2015
- English.
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In: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 62:1, s. 16-23
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Response (tumour volume reduction) to induction chemotherapy has been used to stratify secondary local and systemic treatment of Intergroup Rhabdomyosarcoma Study Group III (IRSG-III) embryonal rhabdomyosarcoma (RME) in consecutive CWS-trials. To evaluate its actual impact we studied response-related treatment and outcomes.PROCEDURE: Patients with IRSG-III RME <21 years and non-response (NR, <33% volume reduction) in five consecutive CWS-trials were analysed and compared with partial responders (PAR, ≥33% reduction). The NR was reviewed and sub-classified as Objective Response (OR, <0%-33% reduction) or Stable/Progressive Disease (SPD).RESULTS: Fifty-nine of 529 patients had NR (n = 34 OR, n = 25 SPD). Primary risk-factors including age, tumour size, and TN-classification did not differ between NR and PAR groups but NR had more patients with unfavourable sites comparatively (P = 0.04). There were no differences in primary risk-factors between OR and SPD. Significant factors associated with poor outcome in multivariate analysis were NR, TN-classification, age >10 years, tumour size >5 cm and therapy in older trials. After response assessment n = 24 NR continued to receive induction chemotherapy, n = 32 received other combinations and n = 3 no further chemotherapy. Forty-two non-responders were irradiated, and the tumours were completely resected in n = 20. After a median follow-up of 8 years, 34 NR are alive. Seventeen of 21 failures leading to disease-related deaths were locoregional. The five-year overall survival rate (OS) was 76 ± 4% for PAR, 79 ± 14% for OR, but only 40 ± 19% for SPD (P < 0.001).CONCLUSION: Response to induction chemotherapy appears to be an important surrogate marker of poor outcome in patients with SPD largely due to ineffective local control.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
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- art (subject category)
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- By the author/editor
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Dantonello, Tobi ...
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Stark, Monika
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Timmermann, Beat ...
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Fuchs, Jörg
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Selle, Barbara
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Linderkamp, Chri ...
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show more...
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Handgretinger, R ...
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Hagen, Rudolf
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Feuchtgruber, Si ...
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Kube, Stefanie
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Kosztyla, Daniel
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Kazanowska, Bern ...
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Ladenstein, Ruth
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Niggli, Felix
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Ljungman, Gustaf ...
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Bielack, Stefan ...
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Klingebiel, Thom ...
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Koscielniak, Ewa
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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Pediatric Blood ...
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Uppsala University