Delayed radiotherapy following dose intensive chemotherapy for parameningeal rhabdomyosarcoma (PM-RMS) of childhood

James G. Douglas, Carola A.S. Arndt, Douglas S. Hawkins

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: To evaluate the local control rates and survival rates of patients with Group III parameningeal rhabdomyosarcoma (PM-RMS) treated with a dose intensive chemotherapy regimen followed by irradiation. Materials and methods: Twenty-six patients with group III, PM-RMS were enrolled in a prospective pilot trial at the Mayo Clinic, Rochester, MN and Children's Hospital and Regional Medical Center Seattle, WA. The median age at diagnosis was 8.5 years (range 1.5-19 years). The male to female patient ratio was 1.6:1. Twenty-three patients had embryonal histology with the remaining three alveolar. Risk factors indicating high risk disease included intracranial extension (10 patients), base of skull erosion (12 patients), and cranial nerve palsy (10 patients). The median follow-up period for all patients was 82 months (range 17-148 months). Patients were treated with an intensified chemotherapy regimen followed by definitive local irradiation at week 12 following further chemotherapy. The median time from initiation of chemotherapy to irradiation was 16 weeks (range 6-23). The median dose delivered was 50.4 Gy (50.4-66.6 Gy). Results: Response was assessed after the fourth course of chemotherapy. Three patients exhibited a complete response, 22 a partial response, and 1 patient had no response after two cycles of chemotherapy and proceeded to irradiation at week 6. The 5-year estimated event free survival was 81% (±15%, 95% CI). Two patients died from progressive metastatic disease; 1 patient died from secondary malignancy; and 2 patients died from locally progressive disease. The 5-year local control rate was 92% (±10.6%, 95% CI). Conclusions: Treatment of group III PM-RMS patients with neo-adjuvant, intensive chemotherapy with a delay in irradiation resulted in excellent local-regional control rates and survival rates and may allow for a response-based radiotherapy approach.

Original languageEnglish (US)
Pages (from-to)1045-1050
Number of pages6
JournalEuropean Journal of Cancer
Volume43
Issue number6
DOIs
StatePublished - Apr 2007

Fingerprint

Rhabdomyosarcoma
Radiotherapy
Drug Therapy
Survival Rate
Cranial Nerve Diseases
Skull Base
Adjuvant Chemotherapy
Disease-Free Survival

Keywords

  • Delayed radiotherapy for Parameningeal rhabdomyosarcoma
  • Parameningeal rhabdomyosarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Delayed radiotherapy following dose intensive chemotherapy for parameningeal rhabdomyosarcoma (PM-RMS) of childhood. / Douglas, James G.; Arndt, Carola A.S.; Hawkins, Douglas S.

In: European Journal of Cancer, Vol. 43, No. 6, 04.2007, p. 1045-1050.

Research output: Contribution to journalArticle

@article{46d26d2b702c48219c2c5348302be0f5,
title = "Delayed radiotherapy following dose intensive chemotherapy for parameningeal rhabdomyosarcoma (PM-RMS) of childhood",
abstract = "Purpose: To evaluate the local control rates and survival rates of patients with Group III parameningeal rhabdomyosarcoma (PM-RMS) treated with a dose intensive chemotherapy regimen followed by irradiation. Materials and methods: Twenty-six patients with group III, PM-RMS were enrolled in a prospective pilot trial at the Mayo Clinic, Rochester, MN and Children's Hospital and Regional Medical Center Seattle, WA. The median age at diagnosis was 8.5 years (range 1.5-19 years). The male to female patient ratio was 1.6:1. Twenty-three patients had embryonal histology with the remaining three alveolar. Risk factors indicating high risk disease included intracranial extension (10 patients), base of skull erosion (12 patients), and cranial nerve palsy (10 patients). The median follow-up period for all patients was 82 months (range 17-148 months). Patients were treated with an intensified chemotherapy regimen followed by definitive local irradiation at week 12 following further chemotherapy. The median time from initiation of chemotherapy to irradiation was 16 weeks (range 6-23). The median dose delivered was 50.4 Gy (50.4-66.6 Gy). Results: Response was assessed after the fourth course of chemotherapy. Three patients exhibited a complete response, 22 a partial response, and 1 patient had no response after two cycles of chemotherapy and proceeded to irradiation at week 6. The 5-year estimated event free survival was 81{\%} (±15{\%}, 95{\%} CI). Two patients died from progressive metastatic disease; 1 patient died from secondary malignancy; and 2 patients died from locally progressive disease. The 5-year local control rate was 92{\%} (±10.6{\%}, 95{\%} CI). Conclusions: Treatment of group III PM-RMS patients with neo-adjuvant, intensive chemotherapy with a delay in irradiation resulted in excellent local-regional control rates and survival rates and may allow for a response-based radiotherapy approach.",
keywords = "Delayed radiotherapy for Parameningeal rhabdomyosarcoma, Parameningeal rhabdomyosarcoma",
author = "Douglas, {James G.} and Arndt, {Carola A.S.} and Hawkins, {Douglas S.}",
year = "2007",
month = "4",
doi = "10.1016/j.ejca.2007.01.033",
language = "English (US)",
volume = "43",
pages = "1045--1050",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Elsevier Limited",
number = "6",

}

TY - JOUR

T1 - Delayed radiotherapy following dose intensive chemotherapy for parameningeal rhabdomyosarcoma (PM-RMS) of childhood

AU - Douglas, James G.

AU - Arndt, Carola A.S.

AU - Hawkins, Douglas S.

PY - 2007/4

Y1 - 2007/4

N2 - Purpose: To evaluate the local control rates and survival rates of patients with Group III parameningeal rhabdomyosarcoma (PM-RMS) treated with a dose intensive chemotherapy regimen followed by irradiation. Materials and methods: Twenty-six patients with group III, PM-RMS were enrolled in a prospective pilot trial at the Mayo Clinic, Rochester, MN and Children's Hospital and Regional Medical Center Seattle, WA. The median age at diagnosis was 8.5 years (range 1.5-19 years). The male to female patient ratio was 1.6:1. Twenty-three patients had embryonal histology with the remaining three alveolar. Risk factors indicating high risk disease included intracranial extension (10 patients), base of skull erosion (12 patients), and cranial nerve palsy (10 patients). The median follow-up period for all patients was 82 months (range 17-148 months). Patients were treated with an intensified chemotherapy regimen followed by definitive local irradiation at week 12 following further chemotherapy. The median time from initiation of chemotherapy to irradiation was 16 weeks (range 6-23). The median dose delivered was 50.4 Gy (50.4-66.6 Gy). Results: Response was assessed after the fourth course of chemotherapy. Three patients exhibited a complete response, 22 a partial response, and 1 patient had no response after two cycles of chemotherapy and proceeded to irradiation at week 6. The 5-year estimated event free survival was 81% (±15%, 95% CI). Two patients died from progressive metastatic disease; 1 patient died from secondary malignancy; and 2 patients died from locally progressive disease. The 5-year local control rate was 92% (±10.6%, 95% CI). Conclusions: Treatment of group III PM-RMS patients with neo-adjuvant, intensive chemotherapy with a delay in irradiation resulted in excellent local-regional control rates and survival rates and may allow for a response-based radiotherapy approach.

AB - Purpose: To evaluate the local control rates and survival rates of patients with Group III parameningeal rhabdomyosarcoma (PM-RMS) treated with a dose intensive chemotherapy regimen followed by irradiation. Materials and methods: Twenty-six patients with group III, PM-RMS were enrolled in a prospective pilot trial at the Mayo Clinic, Rochester, MN and Children's Hospital and Regional Medical Center Seattle, WA. The median age at diagnosis was 8.5 years (range 1.5-19 years). The male to female patient ratio was 1.6:1. Twenty-three patients had embryonal histology with the remaining three alveolar. Risk factors indicating high risk disease included intracranial extension (10 patients), base of skull erosion (12 patients), and cranial nerve palsy (10 patients). The median follow-up period for all patients was 82 months (range 17-148 months). Patients were treated with an intensified chemotherapy regimen followed by definitive local irradiation at week 12 following further chemotherapy. The median time from initiation of chemotherapy to irradiation was 16 weeks (range 6-23). The median dose delivered was 50.4 Gy (50.4-66.6 Gy). Results: Response was assessed after the fourth course of chemotherapy. Three patients exhibited a complete response, 22 a partial response, and 1 patient had no response after two cycles of chemotherapy and proceeded to irradiation at week 6. The 5-year estimated event free survival was 81% (±15%, 95% CI). Two patients died from progressive metastatic disease; 1 patient died from secondary malignancy; and 2 patients died from locally progressive disease. The 5-year local control rate was 92% (±10.6%, 95% CI). Conclusions: Treatment of group III PM-RMS patients with neo-adjuvant, intensive chemotherapy with a delay in irradiation resulted in excellent local-regional control rates and survival rates and may allow for a response-based radiotherapy approach.

KW - Delayed radiotherapy for Parameningeal rhabdomyosarcoma

KW - Parameningeal rhabdomyosarcoma

UR - http://www.scopus.com/inward/record.url?scp=33947694405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947694405&partnerID=8YFLogxK

U2 - 10.1016/j.ejca.2007.01.033

DO - 10.1016/j.ejca.2007.01.033

M3 - Article

C2 - 17368885

AN - SCOPUS:33947694405

VL - 43

SP - 1045

EP - 1050

JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

IS - 6

ER -