The effect of radiation timing on patients with high-risk features of parameningeal rhabdomyosarcoma: An analysis of IRS-IV and D9803

Aaron C. Spalding, Douglas S. Hawkins, Sarah S. Donaldson, James R. Anderson, Elizabeth Lyden, Fran Laurie, Suzanne L. Wolden, Carola A.S. Arndt, Jeff M. Michalski

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose Radiation therapy remains an essential treatment for patients with parameningeal rhabdomyosarcoma (PMRMS), and early radiation therapy may improve local control for patients with intracranial extension (ICE). Methods and Materials To address the role of radiation therapy timing in PMRMS in the current era, we reviewed the outcome from 2 recent clinical trials for intermediate-risk RMS: Intergroup Rhabdomyosarcoma Study (IRS)-IV and Children's Oncology Group (COG) D9803. The PMRMS patients on IRS-IV with any high-risk features (cranial nerve palsy [CNP], cranial base bony erosion [CBBE], or ICE) were treated immediately at day 0, and PMRMS patients without any of these 3 features received week 6-9 radiation therapy. The D9803 PMRMS patients with ICE received day 0 X-Ray Therapy (XRT) as well; however, those with either CNP or CBBE had XRT at week 12. Results Compared with the 198 PMRMS patients from IRS-IV, the 192 PMRMS patients from D9803 had no difference (P<.05) in 5-year local failure (19% vs 19%), failure-free-survival (70% vs 67%), or overall survival (75% vs 73%) in aggregate. The 5-year local failure rates by subset did not differ when patients were classified as having no risk features (None, 15% vs 19%, P=.25), cranial nerve palsy/cranial base of skull erosion (CNP/CBBE, 15% vs 28%, P=.22), or intracranial extension (ICE, 21% vs 15%, P=.27). The D9083 patients were more likely to have received initial staging by magnetic resonance imaging (71% vs 53%). Conclusions These data support that a delay in radiation therapy for high-risk PMRMS features of CNP/CBBE does not compromise clinical outcomes.

Original languageEnglish (US)
Pages (from-to)512-516
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume87
Issue number3
DOIs
StatePublished - Nov 1 2013

Fingerprint

Rhabdomyosarcoma
Radiation Effects
time measurement
nerves
Skull Base
Cranial Nerve Diseases
radiation
erosion
radiation therapy
Radiotherapy
X-Ray Therapy
therapy
skull
Survival
set theory
magnetic resonance
Secondary Prevention
x rays
Magnetic Resonance Imaging
Clinical Trials

ASJC Scopus subject areas

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

Cite this

The effect of radiation timing on patients with high-risk features of parameningeal rhabdomyosarcoma : An analysis of IRS-IV and D9803. / Spalding, Aaron C.; Hawkins, Douglas S.; Donaldson, Sarah S.; Anderson, James R.; Lyden, Elizabeth; Laurie, Fran; Wolden, Suzanne L.; Arndt, Carola A.S.; Michalski, Jeff M.

In: International Journal of Radiation Oncology Biology Physics, Vol. 87, No. 3, 01.11.2013, p. 512-516.

Research output: Contribution to journalArticle

Spalding, Aaron C. ; Hawkins, Douglas S. ; Donaldson, Sarah S. ; Anderson, James R. ; Lyden, Elizabeth ; Laurie, Fran ; Wolden, Suzanne L. ; Arndt, Carola A.S. ; Michalski, Jeff M. / The effect of radiation timing on patients with high-risk features of parameningeal rhabdomyosarcoma : An analysis of IRS-IV and D9803. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 87, No. 3. pp. 512-516.
@article{5389cb1006ef49e3ac1e78120f0abc16,
title = "The effect of radiation timing on patients with high-risk features of parameningeal rhabdomyosarcoma: An analysis of IRS-IV and D9803",
abstract = "Purpose Radiation therapy remains an essential treatment for patients with parameningeal rhabdomyosarcoma (PMRMS), and early radiation therapy may improve local control for patients with intracranial extension (ICE). Methods and Materials To address the role of radiation therapy timing in PMRMS in the current era, we reviewed the outcome from 2 recent clinical trials for intermediate-risk RMS: Intergroup Rhabdomyosarcoma Study (IRS)-IV and Children's Oncology Group (COG) D9803. The PMRMS patients on IRS-IV with any high-risk features (cranial nerve palsy [CNP], cranial base bony erosion [CBBE], or ICE) were treated immediately at day 0, and PMRMS patients without any of these 3 features received week 6-9 radiation therapy. The D9803 PMRMS patients with ICE received day 0 X-Ray Therapy (XRT) as well; however, those with either CNP or CBBE had XRT at week 12. Results Compared with the 198 PMRMS patients from IRS-IV, the 192 PMRMS patients from D9803 had no difference (P<.05) in 5-year local failure (19{\%} vs 19{\%}), failure-free-survival (70{\%} vs 67{\%}), or overall survival (75{\%} vs 73{\%}) in aggregate. The 5-year local failure rates by subset did not differ when patients were classified as having no risk features (None, 15{\%} vs 19{\%}, P=.25), cranial nerve palsy/cranial base of skull erosion (CNP/CBBE, 15{\%} vs 28{\%}, P=.22), or intracranial extension (ICE, 21{\%} vs 15{\%}, P=.27). The D9083 patients were more likely to have received initial staging by magnetic resonance imaging (71{\%} vs 53{\%}). Conclusions These data support that a delay in radiation therapy for high-risk PMRMS features of CNP/CBBE does not compromise clinical outcomes.",
author = "Spalding, {Aaron C.} and Hawkins, {Douglas S.} and Donaldson, {Sarah S.} and Anderson, {James R.} and Elizabeth Lyden and Fran Laurie and Wolden, {Suzanne L.} and Arndt, {Carola A.S.} and Michalski, {Jeff M.}",
year = "2013",
month = "11",
day = "1",
doi = "10.1016/j.ijrobp.2013.07.003",
language = "English (US)",
volume = "87",
pages = "512--516",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - The effect of radiation timing on patients with high-risk features of parameningeal rhabdomyosarcoma

T2 - An analysis of IRS-IV and D9803

AU - Spalding, Aaron C.

AU - Hawkins, Douglas S.

AU - Donaldson, Sarah S.

AU - Anderson, James R.

AU - Lyden, Elizabeth

AU - Laurie, Fran

AU - Wolden, Suzanne L.

AU - Arndt, Carola A.S.

AU - Michalski, Jeff M.

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Purpose Radiation therapy remains an essential treatment for patients with parameningeal rhabdomyosarcoma (PMRMS), and early radiation therapy may improve local control for patients with intracranial extension (ICE). Methods and Materials To address the role of radiation therapy timing in PMRMS in the current era, we reviewed the outcome from 2 recent clinical trials for intermediate-risk RMS: Intergroup Rhabdomyosarcoma Study (IRS)-IV and Children's Oncology Group (COG) D9803. The PMRMS patients on IRS-IV with any high-risk features (cranial nerve palsy [CNP], cranial base bony erosion [CBBE], or ICE) were treated immediately at day 0, and PMRMS patients without any of these 3 features received week 6-9 radiation therapy. The D9803 PMRMS patients with ICE received day 0 X-Ray Therapy (XRT) as well; however, those with either CNP or CBBE had XRT at week 12. Results Compared with the 198 PMRMS patients from IRS-IV, the 192 PMRMS patients from D9803 had no difference (P<.05) in 5-year local failure (19% vs 19%), failure-free-survival (70% vs 67%), or overall survival (75% vs 73%) in aggregate. The 5-year local failure rates by subset did not differ when patients were classified as having no risk features (None, 15% vs 19%, P=.25), cranial nerve palsy/cranial base of skull erosion (CNP/CBBE, 15% vs 28%, P=.22), or intracranial extension (ICE, 21% vs 15%, P=.27). The D9083 patients were more likely to have received initial staging by magnetic resonance imaging (71% vs 53%). Conclusions These data support that a delay in radiation therapy for high-risk PMRMS features of CNP/CBBE does not compromise clinical outcomes.

AB - Purpose Radiation therapy remains an essential treatment for patients with parameningeal rhabdomyosarcoma (PMRMS), and early radiation therapy may improve local control for patients with intracranial extension (ICE). Methods and Materials To address the role of radiation therapy timing in PMRMS in the current era, we reviewed the outcome from 2 recent clinical trials for intermediate-risk RMS: Intergroup Rhabdomyosarcoma Study (IRS)-IV and Children's Oncology Group (COG) D9803. The PMRMS patients on IRS-IV with any high-risk features (cranial nerve palsy [CNP], cranial base bony erosion [CBBE], or ICE) were treated immediately at day 0, and PMRMS patients without any of these 3 features received week 6-9 radiation therapy. The D9803 PMRMS patients with ICE received day 0 X-Ray Therapy (XRT) as well; however, those with either CNP or CBBE had XRT at week 12. Results Compared with the 198 PMRMS patients from IRS-IV, the 192 PMRMS patients from D9803 had no difference (P<.05) in 5-year local failure (19% vs 19%), failure-free-survival (70% vs 67%), or overall survival (75% vs 73%) in aggregate. The 5-year local failure rates by subset did not differ when patients were classified as having no risk features (None, 15% vs 19%, P=.25), cranial nerve palsy/cranial base of skull erosion (CNP/CBBE, 15% vs 28%, P=.22), or intracranial extension (ICE, 21% vs 15%, P=.27). The D9083 patients were more likely to have received initial staging by magnetic resonance imaging (71% vs 53%). Conclusions These data support that a delay in radiation therapy for high-risk PMRMS features of CNP/CBBE does not compromise clinical outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84884876385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884876385&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2013.07.003

DO - 10.1016/j.ijrobp.2013.07.003

M3 - Article

C2 - 24074925

AN - SCOPUS:84884876385

VL - 87

SP - 512

EP - 516

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 3

ER -