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Which Patients With Rhabdomyosarcoma Need Radiotherapy? : Analysis of the Radiotherapy Strategies of the CWS-96 and CWS-2002P Studies and SoTiSaR Registry

Koscielniak, Ewa (författare)
Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany.;Univ Tubingen, Med Fac, Tubingen, Germany.;Klinikum Stuttgart, Zentrum Kinder Jugend & Frauenmed, Olgahosp, Pediat 5 Oncol Hematol Immunol, Kriegsbergstr 62, D-70174 Stuttgart, Germany.
Timmermann, Beate (författare)
Univ Hosp Essen, West German Canc Ctr WTZ, Essen, Germany.
Muenter, Marc (författare)
Hosp Radiat Oncol, Klinikum Stuttgart, Katharinenhosp, Stuttgart, Germany.
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Weclawek-Tompol, Jadwiga (författare)
Univ Wroclaw, Dept Pediat Hematol Oncol & BMT, Wroclaw, Poland.
Ladenstein, Ruth (författare)
St Anna Childrens Hosp, Pediat Oncol, Vienna, Austria.
Niggli, Felix (författare)
Univ Zurich, Dept Pediat Oncol, Zurich, Switzerland.
Ljungman, Gustaf, 1958- (författare)
Uppsala universitet,Barnonkologisk forskning - särskilt fokus på komplikationer
Brecht, Ines B. (författare)
Univ Tubingen, Hosp Children & Adolescents, Dept Pediat Hematol & Oncol, Tubingen, Germany.
Blank, Bernd (författare)
Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany.
Hallmen, Erika (författare)
Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany.
Scheer, Monika (författare)
Charite, Dept Pediat Oncol & Hematol, Berlin, Germany.
Fuchs, Joerg (författare)
Univ Tubingen, Hosp Children & Adolescents, Dept Pediat Surg & Urol, Tubingen, Germany.
Seitz, Guido (författare)
Univ Hosp Giessen Marburg, Dept Pediat Surg & Urol, Marburg, Germany.
Blattmann, Claudia (författare)
Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany.;Univ Tubingen, Med Fac, Tubingen, Germany.
Sparber-Sauer, Monika (författare)
Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany.;Univ Tubingen, Med Fac, Tubingen, Germany.
Klingebiel, Thomas (författare)
Goethe Univ, Univ Hosp Frankfurt, Dept Children & Adolescents, Frankfurt, Germany.
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Klinikum Stuttgart, Olgahosp, Pediat 5 Oncol, Hematol,Immunol, Stuttgart, Germany;Univ Tubingen, Med Fac, Tubingen, Germany.;Klinikum Stuttgart, Zentrum Kinder Jugend & Frauenmed, Olgahosp, Pediat 5 Oncol Hematol Immunol, Kriegsbergstr 62, D-70174 Stuttgart, Germany. Univ Hosp Essen, West German Canc Ctr WTZ, Essen, Germany. (creator_code:org_t)
Lippincott Williams & Wilkins, 2023
2023
Engelska.
Ingår i: Journal of Clinical Oncology. - : Lippincott Williams & Wilkins. - 0732-183X .- 1527-7755. ; 41:31, s. 4916-
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • PURPOSETo analyze and compare the indications, doses, and application methods of radiotherapy (RT) and their influence on prognosis of patients with localized rhabdomyosarcoma (RMS).METHODSOne thousand four hundred seventy patients with localized RMS 21 years and younger entered on CWS-96, CWS-2002P, and SoTiSaR were eligible for the analysis. The median follow-up was 6.5 years (IQR, 3.3-9.5).RESULTSThe 5-year event-free survival (EFS) and local control survival (LCS) for 910 (62%) irradiated versus nonirradiated patients were 71% versus 69% and 78% versus 73% (P = .03), respectively. Ninety-five percent of patients in IRS I (90% embryonal RMS [eRMS]) were nonirradiated (EFS, 87%). Irradiated patients with IRS II had improved LCS (91% v 80%; P = .01) and EFS (not significant). In IRS III, EFS and LCS were significantly better for RT patients: 71% versus 56% (P = 3.1e-06) and 76% versus 61% (P = 4.1e-07). Patients with tumors in the head and neck region (orbita, parameningeal, and nonparameningeal) and in other sites had significantly better EFS and LCS and in parameningeal also overall survival (OS). The efficacy of low RT doses of 32 Gy (hyperfractionated, accelerated RT [HART]) and 36 and 41.4 Gy (conventional fractionated RT [CFRT]) in the favorable groups and higher doses of 44.8 Gy (HART) and 50.4 and 55.4 Gy (CFRT) in the unfavorable groups was comparable. Proton RT was used predominantly in head/neck-parameningeal (HN-PM) tumors, with similar EFS and LCS to photon RT.CONCLUSIONRT can be omitted in patients with IRS I eRMS. RT improves LCS and EFS in IRS II and III. RT improves OS in patients with HN-PM, with proton RT comparable with photon RT. Doses of 32 Gy (HART) or 36 and 41.4 Gy (CFRT) had comparable efficacy in patients with favorable risk profiles and 44.8 Gy (HART) or 50.4 and 55.8 Gy (CFRT) in the unfavorable groups.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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