Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group
Authors
Raney, R. BeverlyWalterhouse, David O.
Meza, Jane L.
Andrassy, Richard J.
Breneman, John C.
Crist, William M.
Maurer, Harold M.
Meyer, William H.
Parham, David M.
Anderson, James R.
Document Type
Journal ArticlePublication Date
2011-04-01Keywords
AdolescentAdult
Antineoplastic Combined Chemotherapy Protocols
Child
Child, Preschool
Cyclophosphamide
Dactinomycin
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Lymphatic Metastasis
Male
Neoplasm Recurrence, Local
Neoplasm Staging
Proportional Hazards Models
Radiation Dosage
Radiotherapy, Adjuvant
Rhabdomyosarcoma, Embryonal
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
United States
Vincristine
Young Adult
Neoplasms
Oncology
Metadata
Show full item recordAbstract
PURPOSE: Patients with localized, grossly resected, or gross residual (orbital only) embryonal rhabdomyosarcoma (ERMS) had 5-year failure-free survival (FFS) rates of 83% and overall survival rates of 95% on Intergroup Rhabdomyosarcoma Study Group (IRSG) protocols III/IV. IRSG D9602 protocol (1997 to 2004) objectives were to decrease toxicity in similar patients by reducing radiotherapy (RT) doses and eliminating cyclophosphamide for the lowest-risk patients. PATIENTS AND METHODS: Subgroup A patients (lowest risk, with ERMS, stage 1 group I/IIA, stage 1 group III orbit, stage 2 group I) received vincristine plus dactinomycin (VA). Subgroup B patients (ERMS, stage 1 group IIB/C, stage I group III nonorbit, stage 2 group II, stage 3 group I/II) received VA plus cyclophosphamide. Patients in group II/III received RT. Compared with IRS-IV, doses were reduced from 41.4 to 36 Gy for stage 1 group IIA patients and from 50 or 59 to 45 Gy for group III orbit patients. RESULTS: Estimated 5-year FFS rates were 89% (95% CI, 84% to 92%) for subgroup A patients (n = 264) and 85% (95% CI, 74%, 91%) for subgroup B patients (n = 78); median follow-up: 5.1 years. Estimated 5-year FFS rates were 81% (95% CI, 68% to 90%) for patients with stage 1 group IIA tumors (n = 62) and 86% (95% CI, 76% to 92%) for patients with group III orbit tumors (n = 77). CONCLUSION: Five-year FFS and OS rates were similar to those observed in comparable IRS-III patients, including patients receiving reduced RT doses, but were lower than in comparable IRS-IV patients receiving VA plus cyclophosphamide. Five-year FFS rates were similar among subgroups A and B patients.Source
J Clin Oncol. 2011 Apr 1;29(10):1312-8. doi: 10.1200/JCO.2010.30.4469. Link to article on publisher's siteDOI
10.1200/JCO.2010.30.4469Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47945PubMed ID
21357783Notes
This study was supported in part by Grant CA-29511 from the National Cancer Institute for the IROC Rhode Island (QARC), a quality assurance vehicle and data management service for diagnostic imaging and radiation oncology for the National Cancer Institute Clinical Trials Program. QARC is a research program within the University of Massachusetts Medical School led by Dr. Thomas (TJ) FitzGerald.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1200/JCO.2010.30.4469