Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma: A report from the intergroup rhabdomyosarcoma studies I to III

Suzanne L. Wolden, James R. Anderson, William M. Crist, John C. Breneman, Moody D. Wharam, Eugene S. Wiener, Stephen J. Qualman, Sarah S. Donaldson

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the outcome of patients with rhabdomyosarcoma (RMS) treated with complete surgical resection and multiagent chemotherapy, with or without local radiotherapy (RT). Patients and Methods: Four hundred thirty- nine patients with completely resected (ie, group I) RMS were further treated with chemotherapy (vincristine and actinomycin D ± cyclophosphamide, doxorubicin, and cisplatin) on Intergroup Rhabdomyosarcoma Studies (IRS) I to III between 1972 and 1991. Eighty-three patients (19%) also received local RT as a component of initial treatment. Results: Eighty-six patients relapsed (10-year failure-free survival [FFS] 79%, overall survival 89%). Six percent of failure sites were local, 6% were regional, and 7% were distant. Poor prognostic factors were tumor size greater than 5 cm, alveolar or undifferentiated histology, primary tumor sites other than genitourinary, and treatment on IRS-I or II. For patients with embryonal RMS who were treated with RT, there was a trend for improved FFS but no difference in overall survival. On IRS-I and II, patients with alveolar or undifferentiated sarcoma who received RT compared with those who did not receive RT had greater 10- year FFS rates (73% v 44%, respectively; P = .03) and overall survival rates (82% v 52%, respectively; (P = .02). Such patients who received RT on IRS III also benefited more than those who did not receive RT (10-year FFS, 95% v 69%; P = .01; overall survival, 95% v 86%; P = .23). Conclusion: Patients with group I embryonal RMS have an excellent prognosis when treated with adjuvant multiagent chemotherapy without RT. Patients with alveolar RMS or undifferentiated sarcoma fare worse; however, FFS and overall survival are substantially improved when RT is added to multiagent chemotherapy (IRS-I and II). The best outcome occurred in IRS-III, when RT was used in conjunction with intensified chemotherapy.

Original languageEnglish (US)
Pages (from-to)3468-3475
Number of pages8
JournalJournal of Clinical Oncology
Volume17
Issue number11
StatePublished - Nov 1999
Externally publishedYes

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Rhabdomyosarcoma
Radiotherapy
Drug Therapy
Survival
Embryonal Rhabdomyosarcoma
Sarcoma
Survival Rate
Pyridinolcarbamate
Alveolar Rhabdomyosarcoma
Dactinomycin
Vincristine
Adjuvant Chemotherapy
Doxorubicin
Cyclophosphamide
Cisplatin
Neoplasms
Histology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Wolden, S. L., Anderson, J. R., Crist, W. M., Breneman, J. C., Wharam, M. D., Wiener, E. S., ... Donaldson, S. S. (1999). Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma: A report from the intergroup rhabdomyosarcoma studies I to III. Journal of Clinical Oncology, 17(11), 3468-3475.

Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma : A report from the intergroup rhabdomyosarcoma studies I to III. / Wolden, Suzanne L.; Anderson, James R.; Crist, William M.; Breneman, John C.; Wharam, Moody D.; Wiener, Eugene S.; Qualman, Stephen J.; Donaldson, Sarah S.

In: Journal of Clinical Oncology, Vol. 17, No. 11, 11.1999, p. 3468-3475.

Research output: Contribution to journalArticle

Wolden, SL, Anderson, JR, Crist, WM, Breneman, JC, Wharam, MD, Wiener, ES, Qualman, SJ & Donaldson, SS 1999, 'Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma: A report from the intergroup rhabdomyosarcoma studies I to III', Journal of Clinical Oncology, vol. 17, no. 11, pp. 3468-3475.
Wolden, Suzanne L. ; Anderson, James R. ; Crist, William M. ; Breneman, John C. ; Wharam, Moody D. ; Wiener, Eugene S. ; Qualman, Stephen J. ; Donaldson, Sarah S. / Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma : A report from the intergroup rhabdomyosarcoma studies I to III. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 11. pp. 3468-3475.
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title = "Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma: A report from the intergroup rhabdomyosarcoma studies I to III",
abstract = "Purpose: To evaluate the outcome of patients with rhabdomyosarcoma (RMS) treated with complete surgical resection and multiagent chemotherapy, with or without local radiotherapy (RT). Patients and Methods: Four hundred thirty- nine patients with completely resected (ie, group I) RMS were further treated with chemotherapy (vincristine and actinomycin D ± cyclophosphamide, doxorubicin, and cisplatin) on Intergroup Rhabdomyosarcoma Studies (IRS) I to III between 1972 and 1991. Eighty-three patients (19{\%}) also received local RT as a component of initial treatment. Results: Eighty-six patients relapsed (10-year failure-free survival [FFS] 79{\%}, overall survival 89{\%}). Six percent of failure sites were local, 6{\%} were regional, and 7{\%} were distant. Poor prognostic factors were tumor size greater than 5 cm, alveolar or undifferentiated histology, primary tumor sites other than genitourinary, and treatment on IRS-I or II. For patients with embryonal RMS who were treated with RT, there was a trend for improved FFS but no difference in overall survival. On IRS-I and II, patients with alveolar or undifferentiated sarcoma who received RT compared with those who did not receive RT had greater 10- year FFS rates (73{\%} v 44{\%}, respectively; P = .03) and overall survival rates (82{\%} v 52{\%}, respectively; (P = .02). Such patients who received RT on IRS III also benefited more than those who did not receive RT (10-year FFS, 95{\%} v 69{\%}; P = .01; overall survival, 95{\%} v 86{\%}; P = .23). Conclusion: Patients with group I embryonal RMS have an excellent prognosis when treated with adjuvant multiagent chemotherapy without RT. Patients with alveolar RMS or undifferentiated sarcoma fare worse; however, FFS and overall survival are substantially improved when RT is added to multiagent chemotherapy (IRS-I and II). The best outcome occurred in IRS-III, when RT was used in conjunction with intensified chemotherapy.",
author = "Wolden, {Suzanne L.} and Anderson, {James R.} and Crist, {William M.} and Breneman, {John C.} and Wharam, {Moody D.} and Wiener, {Eugene S.} and Qualman, {Stephen J.} and Donaldson, {Sarah S.}",
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T1 - Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma

T2 - A report from the intergroup rhabdomyosarcoma studies I to III

AU - Wolden, Suzanne L.

AU - Anderson, James R.

AU - Crist, William M.

AU - Breneman, John C.

AU - Wharam, Moody D.

AU - Wiener, Eugene S.

AU - Qualman, Stephen J.

AU - Donaldson, Sarah S.

PY - 1999/11

Y1 - 1999/11

N2 - Purpose: To evaluate the outcome of patients with rhabdomyosarcoma (RMS) treated with complete surgical resection and multiagent chemotherapy, with or without local radiotherapy (RT). Patients and Methods: Four hundred thirty- nine patients with completely resected (ie, group I) RMS were further treated with chemotherapy (vincristine and actinomycin D ± cyclophosphamide, doxorubicin, and cisplatin) on Intergroup Rhabdomyosarcoma Studies (IRS) I to III between 1972 and 1991. Eighty-three patients (19%) also received local RT as a component of initial treatment. Results: Eighty-six patients relapsed (10-year failure-free survival [FFS] 79%, overall survival 89%). Six percent of failure sites were local, 6% were regional, and 7% were distant. Poor prognostic factors were tumor size greater than 5 cm, alveolar or undifferentiated histology, primary tumor sites other than genitourinary, and treatment on IRS-I or II. For patients with embryonal RMS who were treated with RT, there was a trend for improved FFS but no difference in overall survival. On IRS-I and II, patients with alveolar or undifferentiated sarcoma who received RT compared with those who did not receive RT had greater 10- year FFS rates (73% v 44%, respectively; P = .03) and overall survival rates (82% v 52%, respectively; (P = .02). Such patients who received RT on IRS III also benefited more than those who did not receive RT (10-year FFS, 95% v 69%; P = .01; overall survival, 95% v 86%; P = .23). Conclusion: Patients with group I embryonal RMS have an excellent prognosis when treated with adjuvant multiagent chemotherapy without RT. Patients with alveolar RMS or undifferentiated sarcoma fare worse; however, FFS and overall survival are substantially improved when RT is added to multiagent chemotherapy (IRS-I and II). The best outcome occurred in IRS-III, when RT was used in conjunction with intensified chemotherapy.

AB - Purpose: To evaluate the outcome of patients with rhabdomyosarcoma (RMS) treated with complete surgical resection and multiagent chemotherapy, with or without local radiotherapy (RT). Patients and Methods: Four hundred thirty- nine patients with completely resected (ie, group I) RMS were further treated with chemotherapy (vincristine and actinomycin D ± cyclophosphamide, doxorubicin, and cisplatin) on Intergroup Rhabdomyosarcoma Studies (IRS) I to III between 1972 and 1991. Eighty-three patients (19%) also received local RT as a component of initial treatment. Results: Eighty-six patients relapsed (10-year failure-free survival [FFS] 79%, overall survival 89%). Six percent of failure sites were local, 6% were regional, and 7% were distant. Poor prognostic factors were tumor size greater than 5 cm, alveolar or undifferentiated histology, primary tumor sites other than genitourinary, and treatment on IRS-I or II. For patients with embryonal RMS who were treated with RT, there was a trend for improved FFS but no difference in overall survival. On IRS-I and II, patients with alveolar or undifferentiated sarcoma who received RT compared with those who did not receive RT had greater 10- year FFS rates (73% v 44%, respectively; P = .03) and overall survival rates (82% v 52%, respectively; (P = .02). Such patients who received RT on IRS III also benefited more than those who did not receive RT (10-year FFS, 95% v 69%; P = .01; overall survival, 95% v 86%; P = .23). Conclusion: Patients with group I embryonal RMS have an excellent prognosis when treated with adjuvant multiagent chemotherapy without RT. Patients with alveolar RMS or undifferentiated sarcoma fare worse; however, FFS and overall survival are substantially improved when RT is added to multiagent chemotherapy (IRS-I and II). The best outcome occurred in IRS-III, when RT was used in conjunction with intensified chemotherapy.

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