Early treatment failure in intermediate-risk rhabdomyosarcoma: Results from IRS-IV and D9803 - A report from the Children's Oncology Group

A. Yuriko Minn, Elizabeth R. Lyden, James R. Anderson, Lynn Million, Carola A. Arndt, Kenneth Brown, Douglas S. Hawkins, Sarah S. Donaldson

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Purpose: The goal of this study was to determine the frequency and clinical features of early treatment failure during induction chemotherapy before protocol radiation therapy for children with intermediate-risk rhabdomyosarcoma (RMS). Patients and Methods: Patients with intermediate-risk RMS enrolled onto the Intergroup Rhabdomyosarcoma Study-IV and the Children's Oncology Group D9803 study were reviewed for an early treatment failure. Early failure was defined as failure caused by progressive disease, death as a result of progressive disease, or death as a result of other causes occurring fewer than 120 days from study entry. Patients with parameningeal site RMS with high-risk features who received radiation therapy at week 1 were excluded from analysis. Overall survival (OS) was estimated using the Kaplan-Meier method. Fisher's exact test was used to compare differences between groups. Cumulative incidence of progression was estimated. Results: Of 916 patients, 20 (2.2%) were found to have an early disease progression and did not receive planned protocol radiotherapy. Three additional early failures resulted from treatment-related death without progression. Median time to failure was 48 days (range, 7 to 106 days). Nineteen (95%) of the 20 patients experienced progression at their primary site. Five-year OS was 32% (95% CI, 12% to 54%) for patients experiencing an early progression. Conclusion: A small proportion of patients with intermediate-risk RMS suffer an early failure as a result of early progression (2.2%) or treatment-related mortality (0.3%). The majority of patients with early progression had a local failure. Earlier radiotherapy could potentially improve outcome by preventing early local progression.

Original languageEnglish (US)
Pages (from-to)4228-4232
Number of pages5
JournalJournal of Clinical Oncology
Volume28
Issue number27
DOIs
StatePublished - Sep 20 2010

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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