Assessment of response to induction therapy and its influence on 5-year failure-free survival in group III rhabdomyosarcoma: The intergroup rhabdomyosarcoma study-IV experience - A report from the soft tissue sarcoma committee of the children's oncology group Journal Article


Authors: Burke, M.; Anderson, J. R.; Kao, S. C.; Rodeberg, D.; Qualman, S. J.; Wolden, S. L.; Meyer, W. H.; Breitfeld, P. P.
Article Title: Assessment of response to induction therapy and its influence on 5-year failure-free survival in group III rhabdomyosarcoma: The intergroup rhabdomyosarcoma study-IV experience - A report from the soft tissue sarcoma committee of the children's oncology group
Abstract: Purpose Initial response to induction chemotherapy predicts failure-free survival (FFS) in osteosarcoma and Ewing's sarcoma. For Intergroup Rhabdomyosarcoma Study (IRS) IV patients with group III rhabdomyosarcoma, we assessed whether reported response assessed by anatomic imaging at week 8 predicted FFS. Patients and Methods We studied 444 group III patients who received induction therapy, had response assessed at week 8 by anatomic imaging, and continued with protocol therapy. Induction chemotherapy was generally followed by radiation therapy (RT) starting after week 9. Response to induction therapy was determined at weeks 0 and 8. Local institutions coded response. Results Response rate for the entire cohort at week 8 was 77% (95% CI, 73% to 81%; complete response [CR], 21%; partial response [PR], 56%) but response had no influence on FFS (P = .57). Two hundred seventy-two patients received standard-timing RT at week 9 and thus only chemotherapy during induction. Response rate was 81% (95% CI, 76% to 86%; CR, 22%; PR, 59%). In these patients, response did not influence FFS except for those with alveolar histology. One hundred thirty-two other patients received chemotherapy and RT during induction (up-front RT). Response rate was 65% (95% CI, 57% to 73%; CR, 12%; PR, 53%), but response had no influence on FFS (P = .69). Forty patients received no RT at all (protocol violation) and response to induction therapy had no effect on FFS. Conclusion In IRS-IV, response rate to induction therapy was 77% in group III patients, was independent of histology, and had no influence on FFS overall.
Keywords: ewing sarcoma; childhood; neoadjuvant chemotherapy; adolescence; positron-emission-tomography; prognostic-significance; features; disease; acute lymphoblastic-leukemia; pediatric-oncology
Journal Title: Journal of Clinical Oncology
Volume: 25
Issue: 31
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2007-11-01
Start Page: 4909
End Page: 4913
Language: English
ACCESSION: WOS:000251074100009
DOI: 10.1200/jco.2006.10.4257
PROVIDER: wos
PUBMED: 17971587
Notes: --- - Article - "Source: Wos"
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  1. Suzanne L Wolden
    534 Wolden