Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma: A report from the soft tissue sarcoma committee of the Children's Oncology Group

David O. Walterhouse, Alberto S. Pappo, Jane L Meza, John C. Breneman, Andrea A. Hayes-Jordan, David M. Parham, Timothy P. Cripe, James R. Anderson, William H. Meyer, Douglas S. Hawkins

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Results: With a median follow-up of 4. 3 years, we observed 35 failures among 271 eligible patients versus 48. 4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89% (95% CI, 85% to 92%), and the overall survival rate was 98% (95% CI, 95% to 99%). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7. 6%, 1. 5%, and 3. 4%, respectively.

Conclusion: Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.

Purpose: Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failurefree survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26. 4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4. 8 g/m2) plus radiotherapy (RT).

Patients and Methods: This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT.

Original languageEnglish (US)
Pages (from-to)3547-3552
Number of pages6
JournalJournal of Clinical Oncology
Volume32
Issue number31
DOIs
StatePublished - Nov 1 2014

Fingerprint

Rhabdomyosarcoma
Dactinomycin
Vincristine
Sarcoma
Cyclophosphamide
Radiotherapy
Therapeutics
Survival Rate
Survival
Embryonal Rhabdomyosarcoma
Orbit
Clinical Trials
Incidence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma : A report from the soft tissue sarcoma committee of the Children's Oncology Group. / Walterhouse, David O.; Pappo, Alberto S.; Meza, Jane L; Breneman, John C.; Hayes-Jordan, Andrea A.; Parham, David M.; Cripe, Timothy P.; Anderson, James R.; Meyer, William H.; Hawkins, Douglas S.

In: Journal of Clinical Oncology, Vol. 32, No. 31, 01.11.2014, p. 3547-3552.

Research output: Contribution to journalArticle

Walterhouse, David O. ; Pappo, Alberto S. ; Meza, Jane L ; Breneman, John C. ; Hayes-Jordan, Andrea A. ; Parham, David M. ; Cripe, Timothy P. ; Anderson, James R. ; Meyer, William H. ; Hawkins, Douglas S. / Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma : A report from the soft tissue sarcoma committee of the Children's Oncology Group. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 31. pp. 3547-3552.
@article{322784b6e47f42aa8c196c8349478c55,
title = "Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma: A report from the soft tissue sarcoma committee of the Children's Oncology Group",
abstract = "Results: With a median follow-up of 4. 3 years, we observed 35 failures among 271 eligible patients versus 48. 4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89{\%} (95{\%} CI, 85{\%} to 92{\%}), and the overall survival rate was 98{\%} (95{\%} CI, 95{\%} to 99{\%}). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7. 6{\%}, 1. 5{\%}, and 3. 4{\%}, respectively.Conclusion: Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.Purpose: Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failurefree survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26. 4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4. 8 g/m2) plus radiotherapy (RT).Patients and Methods: This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT.",
author = "Walterhouse, {David O.} and Pappo, {Alberto S.} and Meza, {Jane L} and Breneman, {John C.} and Hayes-Jordan, {Andrea A.} and Parham, {David M.} and Cripe, {Timothy P.} and Anderson, {James R.} and Meyer, {William H.} and Hawkins, {Douglas S.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1200/JCO.2014.55.6787",
language = "English (US)",
volume = "32",
pages = "3547--3552",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "31",

}

TY - JOUR

T1 - Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma

T2 - A report from the soft tissue sarcoma committee of the Children's Oncology Group

AU - Walterhouse, David O.

AU - Pappo, Alberto S.

AU - Meza, Jane L

AU - Breneman, John C.

AU - Hayes-Jordan, Andrea A.

AU - Parham, David M.

AU - Cripe, Timothy P.

AU - Anderson, James R.

AU - Meyer, William H.

AU - Hawkins, Douglas S.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Results: With a median follow-up of 4. 3 years, we observed 35 failures among 271 eligible patients versus 48. 4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89% (95% CI, 85% to 92%), and the overall survival rate was 98% (95% CI, 95% to 99%). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7. 6%, 1. 5%, and 3. 4%, respectively.Conclusion: Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.Purpose: Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failurefree survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26. 4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4. 8 g/m2) plus radiotherapy (RT).Patients and Methods: This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT.

AB - Results: With a median follow-up of 4. 3 years, we observed 35 failures among 271 eligible patients versus 48. 4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89% (95% CI, 85% to 92%), and the overall survival rate was 98% (95% CI, 95% to 99%). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7. 6%, 1. 5%, and 3. 4%, respectively.Conclusion: Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.Purpose: Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failurefree survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26. 4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4. 8 g/m2) plus radiotherapy (RT).Patients and Methods: This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT.

UR - http://www.scopus.com/inward/record.url?scp=84911895687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911895687&partnerID=8YFLogxK

U2 - 10.1200/JCO.2014.55.6787

DO - 10.1200/JCO.2014.55.6787

M3 - Article

C2 - 25267746

AN - SCOPUS:84911895687

VL - 32

SP - 3547

EP - 3552

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 31

ER -