Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy

Akila Viswanathan, Holcombe E. Grier, Heather J. Litman, Antonio Perez-Atayde, Nancy J. Tarbell, Donna Neuberg, Robert C. Shamberger, Karen J. Marcus

Research output: Contribution to journalArticle

Abstract

Purpose To analyze the sites of relapse, relapse-free survival, and overall survival in children with Group III rhabdomyosarcoma treated with or without radiotherapy (RT). Methods and materials The outcomes of 48 children with Group III rhabdomyosarcoma treated between 1980 and 1997 were evaluated. The median overall survival follow-up was 7.3 years. Of the 48 patients, 65% had embryonal histology. Local treatment after induction chemotherapy included complete surgical resection (CSR) alone in 9 (19%), CSR plus RT in 13 (27%), partial resection or rebiopsy plus RT in 10 (21%), and RT alone in 15 patients (31%). One child developed distant disease before completing local therapy. Results Of the 48 patients, 12 developed relapse at local (n = 3), regional (n = 4), or distant (n = 5) sites. All 9 patients treated with CSR after induction chemotherapy had embryonal/botryoid histology. Only 1 of these 9 patients developed relapse. No statistically significant difference was found in overall survival (p = 0.95) or relapse-free survival (p = 0.67) between patients treated with or without RT. The Kaplan-Meier estimate of 5-year overall survival and relapse-free survival was 76% ± 7% and 74% ± 7%, respectively. Significant predictors of relapse-free survival on univariate analysis included CSR (p = 0.03), nodal positivity (p = 0.001), and embryonal histology (p = 0.0003). On multivariate analysis, embryonal histology was the most significant predictor of relapse-free (p = 0.001) and overall (p = 0.01) survival. Conclusion The overall survival for children with Group III rhabdomyosarcoma in this series was favorable. Embryonal/botryoid histology was the most significant predictor of both overall and relapse-free survival. We found that for a selected subgroup of children with embryonal histology, induction chemotherapy followed by complete surgical resection alone may be adequate local therapy.

Original languageEnglish (US)
Pages (from-to)1208-1214
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume58
Issue number4
DOIs
StatePublished - Mar 15 2004
Externally publishedYes

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Rhabdomyosarcoma
radiation therapy
Radiotherapy
histology
Survival
Recurrence
Histology
Induction Chemotherapy
chemotherapy
induction
therapy
predictions
Kaplan-Meier Estimate
subgroups
Therapeutics
Multivariate Analysis

Keywords

  • Chemotherapy
  • Pediatric
  • Radiotherapy
  • Rhabdomyosarcoma
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy. / Viswanathan, Akila; Grier, Holcombe E.; Litman, Heather J.; Perez-Atayde, Antonio; Tarbell, Nancy J.; Neuberg, Donna; Shamberger, Robert C.; Marcus, Karen J.

In: International Journal of Radiation Oncology Biology Physics, Vol. 58, No. 4, 15.03.2004, p. 1208-1214.

Research output: Contribution to journalArticle

Viswanathan, A, Grier, HE, Litman, HJ, Perez-Atayde, A, Tarbell, NJ, Neuberg, D, Shamberger, RC & Marcus, KJ 2004, 'Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy', International Journal of Radiation Oncology Biology Physics, vol. 58, no. 4, pp. 1208-1214. https://doi.org/10.1016/j.ijrobp.2003.08.027
Viswanathan, Akila ; Grier, Holcombe E. ; Litman, Heather J. ; Perez-Atayde, Antonio ; Tarbell, Nancy J. ; Neuberg, Donna ; Shamberger, Robert C. ; Marcus, Karen J. / Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy. In: International Journal of Radiation Oncology Biology Physics. 2004 ; Vol. 58, No. 4. pp. 1208-1214.
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title = "Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy",
abstract = "Purpose To analyze the sites of relapse, relapse-free survival, and overall survival in children with Group III rhabdomyosarcoma treated with or without radiotherapy (RT). Methods and materials The outcomes of 48 children with Group III rhabdomyosarcoma treated between 1980 and 1997 were evaluated. The median overall survival follow-up was 7.3 years. Of the 48 patients, 65{\%} had embryonal histology. Local treatment after induction chemotherapy included complete surgical resection (CSR) alone in 9 (19{\%}), CSR plus RT in 13 (27{\%}), partial resection or rebiopsy plus RT in 10 (21{\%}), and RT alone in 15 patients (31{\%}). One child developed distant disease before completing local therapy. Results Of the 48 patients, 12 developed relapse at local (n = 3), regional (n = 4), or distant (n = 5) sites. All 9 patients treated with CSR after induction chemotherapy had embryonal/botryoid histology. Only 1 of these 9 patients developed relapse. No statistically significant difference was found in overall survival (p = 0.95) or relapse-free survival (p = 0.67) between patients treated with or without RT. The Kaplan-Meier estimate of 5-year overall survival and relapse-free survival was 76{\%} ± 7{\%} and 74{\%} ± 7{\%}, respectively. Significant predictors of relapse-free survival on univariate analysis included CSR (p = 0.03), nodal positivity (p = 0.001), and embryonal histology (p = 0.0003). On multivariate analysis, embryonal histology was the most significant predictor of relapse-free (p = 0.001) and overall (p = 0.01) survival. Conclusion The overall survival for children with Group III rhabdomyosarcoma in this series was favorable. Embryonal/botryoid histology was the most significant predictor of both overall and relapse-free survival. We found that for a selected subgroup of children with embryonal histology, induction chemotherapy followed by complete surgical resection alone may be adequate local therapy.",
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author = "Akila Viswanathan and Grier, {Holcombe E.} and Litman, {Heather J.} and Antonio Perez-Atayde and Tarbell, {Nancy J.} and Donna Neuberg and Shamberger, {Robert C.} and Marcus, {Karen J.}",
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T1 - Outcome for children with group III rhabdomyosarcoma treated with or without radiotherapy

AU - Viswanathan, Akila

AU - Grier, Holcombe E.

AU - Litman, Heather J.

AU - Perez-Atayde, Antonio

AU - Tarbell, Nancy J.

AU - Neuberg, Donna

AU - Shamberger, Robert C.

AU - Marcus, Karen J.

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N2 - Purpose To analyze the sites of relapse, relapse-free survival, and overall survival in children with Group III rhabdomyosarcoma treated with or without radiotherapy (RT). Methods and materials The outcomes of 48 children with Group III rhabdomyosarcoma treated between 1980 and 1997 were evaluated. The median overall survival follow-up was 7.3 years. Of the 48 patients, 65% had embryonal histology. Local treatment after induction chemotherapy included complete surgical resection (CSR) alone in 9 (19%), CSR plus RT in 13 (27%), partial resection or rebiopsy plus RT in 10 (21%), and RT alone in 15 patients (31%). One child developed distant disease before completing local therapy. Results Of the 48 patients, 12 developed relapse at local (n = 3), regional (n = 4), or distant (n = 5) sites. All 9 patients treated with CSR after induction chemotherapy had embryonal/botryoid histology. Only 1 of these 9 patients developed relapse. No statistically significant difference was found in overall survival (p = 0.95) or relapse-free survival (p = 0.67) between patients treated with or without RT. The Kaplan-Meier estimate of 5-year overall survival and relapse-free survival was 76% ± 7% and 74% ± 7%, respectively. Significant predictors of relapse-free survival on univariate analysis included CSR (p = 0.03), nodal positivity (p = 0.001), and embryonal histology (p = 0.0003). On multivariate analysis, embryonal histology was the most significant predictor of relapse-free (p = 0.001) and overall (p = 0.01) survival. Conclusion The overall survival for children with Group III rhabdomyosarcoma in this series was favorable. Embryonal/botryoid histology was the most significant predictor of both overall and relapse-free survival. We found that for a selected subgroup of children with embryonal histology, induction chemotherapy followed by complete surgical resection alone may be adequate local therapy.

AB - Purpose To analyze the sites of relapse, relapse-free survival, and overall survival in children with Group III rhabdomyosarcoma treated with or without radiotherapy (RT). Methods and materials The outcomes of 48 children with Group III rhabdomyosarcoma treated between 1980 and 1997 were evaluated. The median overall survival follow-up was 7.3 years. Of the 48 patients, 65% had embryonal histology. Local treatment after induction chemotherapy included complete surgical resection (CSR) alone in 9 (19%), CSR plus RT in 13 (27%), partial resection or rebiopsy plus RT in 10 (21%), and RT alone in 15 patients (31%). One child developed distant disease before completing local therapy. Results Of the 48 patients, 12 developed relapse at local (n = 3), regional (n = 4), or distant (n = 5) sites. All 9 patients treated with CSR after induction chemotherapy had embryonal/botryoid histology. Only 1 of these 9 patients developed relapse. No statistically significant difference was found in overall survival (p = 0.95) or relapse-free survival (p = 0.67) between patients treated with or without RT. The Kaplan-Meier estimate of 5-year overall survival and relapse-free survival was 76% ± 7% and 74% ± 7%, respectively. Significant predictors of relapse-free survival on univariate analysis included CSR (p = 0.03), nodal positivity (p = 0.001), and embryonal histology (p = 0.0003). On multivariate analysis, embryonal histology was the most significant predictor of relapse-free (p = 0.001) and overall (p = 0.01) survival. Conclusion The overall survival for children with Group III rhabdomyosarcoma in this series was favorable. Embryonal/botryoid histology was the most significant predictor of both overall and relapse-free survival. We found that for a selected subgroup of children with embryonal histology, induction chemotherapy followed by complete surgical resection alone may be adequate local therapy.

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