Local control for intermediate-risk rhabdomyosarcoma: Results from D9803 according to histology, group, site, and size: A report from the children's oncology group

Suzanne L. Wolden, Elizabeth R. Lyden, Carola A.S. Arndt, Douglas S. Hawkins, James R. Anderson, David A. Rodeberg, Carol D. Morris, Sarah S. Donaldson

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose To determine local control according to clinical variables for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children's Oncology Group protocol D9803. Patients and Methods Of 702 patients enrolled, we analyzed 423 patients with central pathology-confirmed group III embryonal (n=280) or alveolar (group III, n=102; group I-II, n=41) RMS. Median age was 5 years. Patients received 42 weeks of VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VTC (T = topotecan). Local therapy with 50.4 Gy radiation therapy with or without delayed primary excision began at week 12 for group III patients. Patients with group I/II alveolar RMS received 36-41.4 Gy. Local failure (LF) was defined as local progression as a first event with or without concurrent regional or distant failure. Results At a median follow-up of 6.6 years, patients with clinical group I/II alveolar RMS had a 5-year event-free survival rate of 69% and LF of 10%. Among patients with group III RMS, 5-year event-free survival and LF rates were 70% and 19%, respectively. Local failure rates did not differ by histology, nodal status, or primary site, though there was a trend for increased LF for retroperitoneal (RP) tumors (P=.12). Tumors ≥5 cm were more likely to fail locally than tumors <5 cm (25% vs 10%, P=.0004). Almost all (98%) RP tumors were ≥5 cm, with no difference in LF by site when the analysis was restricted to tumors ≥5 cm (P=.86). Conclusion Local control was excellent for clinical group I/II alveolar RMS. Local failure constituted 63% of initial events in clinical group III patients and did not vary by histology or nodal status. The trend for higher LF in RP tumors was related to tumor size. There has been no clear change in local control over RMS studies, including IRS-III and IRS-IV. Novel approaches are warranted for larger tumors (≥5 cm).

Original languageEnglish (US)
Pages (from-to)1071-1076
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume93
Issue number5
DOIs
StatePublished - Dec 1 2015

Fingerprint

histology
Rhabdomyosarcoma
Histology
tumors
Alveolar Rhabdomyosarcoma
Neoplasms
Indian spacecraft
Dactinomycin
Vincristine
Cyclophosphamide
Disease-Free Survival
Topotecan
trends
Radiation Dosage
pathology
progressions
radiation therapy
therapy
Radiotherapy
Survival Rate

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Local control for intermediate-risk rhabdomyosarcoma : Results from D9803 according to histology, group, site, and size: A report from the children's oncology group. / Wolden, Suzanne L.; Lyden, Elizabeth R.; Arndt, Carola A.S.; Hawkins, Douglas S.; Anderson, James R.; Rodeberg, David A.; Morris, Carol D.; Donaldson, Sarah S.

In: International Journal of Radiation Oncology Biology Physics, Vol. 93, No. 5, 01.12.2015, p. 1071-1076.

Research output: Contribution to journalArticle

Wolden, Suzanne L. ; Lyden, Elizabeth R. ; Arndt, Carola A.S. ; Hawkins, Douglas S. ; Anderson, James R. ; Rodeberg, David A. ; Morris, Carol D. ; Donaldson, Sarah S. / Local control for intermediate-risk rhabdomyosarcoma : Results from D9803 according to histology, group, site, and size: A report from the children's oncology group. In: International Journal of Radiation Oncology Biology Physics. 2015 ; Vol. 93, No. 5. pp. 1071-1076.
@article{2124a934bd13484e9621e9fa71eb9710,
title = "Local control for intermediate-risk rhabdomyosarcoma: Results from D9803 according to histology, group, site, and size: A report from the children's oncology group",
abstract = "Purpose To determine local control according to clinical variables for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children's Oncology Group protocol D9803. Patients and Methods Of 702 patients enrolled, we analyzed 423 patients with central pathology-confirmed group III embryonal (n=280) or alveolar (group III, n=102; group I-II, n=41) RMS. Median age was 5 years. Patients received 42 weeks of VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VTC (T = topotecan). Local therapy with 50.4 Gy radiation therapy with or without delayed primary excision began at week 12 for group III patients. Patients with group I/II alveolar RMS received 36-41.4 Gy. Local failure (LF) was defined as local progression as a first event with or without concurrent regional or distant failure. Results At a median follow-up of 6.6 years, patients with clinical group I/II alveolar RMS had a 5-year event-free survival rate of 69{\%} and LF of 10{\%}. Among patients with group III RMS, 5-year event-free survival and LF rates were 70{\%} and 19{\%}, respectively. Local failure rates did not differ by histology, nodal status, or primary site, though there was a trend for increased LF for retroperitoneal (RP) tumors (P=.12). Tumors ≥5 cm were more likely to fail locally than tumors <5 cm (25{\%} vs 10{\%}, P=.0004). Almost all (98{\%}) RP tumors were ≥5 cm, with no difference in LF by site when the analysis was restricted to tumors ≥5 cm (P=.86). Conclusion Local control was excellent for clinical group I/II alveolar RMS. Local failure constituted 63{\%} of initial events in clinical group III patients and did not vary by histology or nodal status. The trend for higher LF in RP tumors was related to tumor size. There has been no clear change in local control over RMS studies, including IRS-III and IRS-IV. Novel approaches are warranted for larger tumors (≥5 cm).",
author = "Wolden, {Suzanne L.} and Lyden, {Elizabeth R.} and Arndt, {Carola A.S.} and Hawkins, {Douglas S.} and Anderson, {James R.} and Rodeberg, {David A.} and Morris, {Carol D.} and Donaldson, {Sarah S.}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.ijrobp.2015.08.040",
language = "English (US)",
volume = "93",
pages = "1071--1076",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Local control for intermediate-risk rhabdomyosarcoma

T2 - Results from D9803 according to histology, group, site, and size: A report from the children's oncology group

AU - Wolden, Suzanne L.

AU - Lyden, Elizabeth R.

AU - Arndt, Carola A.S.

AU - Hawkins, Douglas S.

AU - Anderson, James R.

AU - Rodeberg, David A.

AU - Morris, Carol D.

AU - Donaldson, Sarah S.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Purpose To determine local control according to clinical variables for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children's Oncology Group protocol D9803. Patients and Methods Of 702 patients enrolled, we analyzed 423 patients with central pathology-confirmed group III embryonal (n=280) or alveolar (group III, n=102; group I-II, n=41) RMS. Median age was 5 years. Patients received 42 weeks of VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VTC (T = topotecan). Local therapy with 50.4 Gy radiation therapy with or without delayed primary excision began at week 12 for group III patients. Patients with group I/II alveolar RMS received 36-41.4 Gy. Local failure (LF) was defined as local progression as a first event with or without concurrent regional or distant failure. Results At a median follow-up of 6.6 years, patients with clinical group I/II alveolar RMS had a 5-year event-free survival rate of 69% and LF of 10%. Among patients with group III RMS, 5-year event-free survival and LF rates were 70% and 19%, respectively. Local failure rates did not differ by histology, nodal status, or primary site, though there was a trend for increased LF for retroperitoneal (RP) tumors (P=.12). Tumors ≥5 cm were more likely to fail locally than tumors <5 cm (25% vs 10%, P=.0004). Almost all (98%) RP tumors were ≥5 cm, with no difference in LF by site when the analysis was restricted to tumors ≥5 cm (P=.86). Conclusion Local control was excellent for clinical group I/II alveolar RMS. Local failure constituted 63% of initial events in clinical group III patients and did not vary by histology or nodal status. The trend for higher LF in RP tumors was related to tumor size. There has been no clear change in local control over RMS studies, including IRS-III and IRS-IV. Novel approaches are warranted for larger tumors (≥5 cm).

AB - Purpose To determine local control according to clinical variables for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children's Oncology Group protocol D9803. Patients and Methods Of 702 patients enrolled, we analyzed 423 patients with central pathology-confirmed group III embryonal (n=280) or alveolar (group III, n=102; group I-II, n=41) RMS. Median age was 5 years. Patients received 42 weeks of VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VTC (T = topotecan). Local therapy with 50.4 Gy radiation therapy with or without delayed primary excision began at week 12 for group III patients. Patients with group I/II alveolar RMS received 36-41.4 Gy. Local failure (LF) was defined as local progression as a first event with or without concurrent regional or distant failure. Results At a median follow-up of 6.6 years, patients with clinical group I/II alveolar RMS had a 5-year event-free survival rate of 69% and LF of 10%. Among patients with group III RMS, 5-year event-free survival and LF rates were 70% and 19%, respectively. Local failure rates did not differ by histology, nodal status, or primary site, though there was a trend for increased LF for retroperitoneal (RP) tumors (P=.12). Tumors ≥5 cm were more likely to fail locally than tumors <5 cm (25% vs 10%, P=.0004). Almost all (98%) RP tumors were ≥5 cm, with no difference in LF by site when the analysis was restricted to tumors ≥5 cm (P=.86). Conclusion Local control was excellent for clinical group I/II alveolar RMS. Local failure constituted 63% of initial events in clinical group III patients and did not vary by histology or nodal status. The trend for higher LF in RP tumors was related to tumor size. There has been no clear change in local control over RMS studies, including IRS-III and IRS-IV. Novel approaches are warranted for larger tumors (≥5 cm).

UR - http://www.scopus.com/inward/record.url?scp=84946782212&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946782212&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2015.08.040

DO - 10.1016/j.ijrobp.2015.08.040

M3 - Article

C2 - 26581144

AN - SCOPUS:84946782212

VL - 93

SP - 1071

EP - 1076

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -