Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy: A pediatric oncology group study

C. B. Pratt, H. M. Maurer, P. Gieser, A. Salzberg, B. N. Rao, D. Parham, P. R.M. Thomas, R. B. Marcus, A. Cantor, T. Pick, D. Green, J. Neff, J. J. Jenkins

Research output: Contribution to journalArticle

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Abstract

Background. The objectives of this study were to compare vincristine/actinomycin D/cyclophosphamide/adriamycin (VACA) with VACA plus imidazole carboxamide (DTIC) (VACAD) therapy in regards to complete/partial response and event free survival rates in children and adolescents with metastatic non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) or previously chemotherapy-naive recurrent NRSTS or locally persistent gross residual tumor after surgery and radiation therapy. Procedures. Between 1986 and March 1994, 75 patients entered this randomized study comparing VACA and VACAD, given at 3 week intervals. Sixty-one patients were considered eligible and received chemotherapy and radiation therapy to the primary tumor and areas of metastases. Thirty-six patients had regional unresected (Group III) disease, and 25 had metastatic disease (Group IV) at time of accession. Thirty-six patients received VACA (11 were not randomized), and 25 received VACAD. Results. With a median follow-up of greater than 4 years, overall and event- free survival for all eligible patients are 30.6% and 18.4%, respectively (S.E: 9.5% and 6.8%). There was insufficient evidence that DTIC offered any advantage to event free survival, but there was evidence for better outcome for patients in Group III disease in comparison to patients with Group IV disease, and for patients with a Grade 1 and 2 histology in comparison to Grade 3 lesions. Conclusions. Combination chemotherapy with VACA and VACAD were insufficient to prevent recurrent or progressive disease in children and adolescents with high stage NRSTS. The use of vincristine/ifosfamide/doxorubicin with cytokine support is under study.

Original languageEnglish (US)
Pages (from-to)201-209
Number of pages9
JournalMedical and Pediatric Oncology
Volume30
Issue number4
DOIs
StatePublished - Jan 1 1998

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Sarcoma
Vincristine
Dacarbazine
Doxorubicin
Pediatrics
Dactinomycin
Drug Therapy
Cyclophosphamide
Disease-Free Survival
Therapeutics
Radiotherapy
Ifosfamide
Residual Neoplasm
Combination Drug Therapy
Histology
Survival Rate
Cytokines
Neoplasm Metastasis
imidazole
Neoplasms

Keywords

  • Childhood tumors
  • Non-rhabdomyosarcoma
  • Sarcomas
  • Stage
  • Tumor grade

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Cancer Research

Cite this

Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy : A pediatric oncology group study. / Pratt, C. B.; Maurer, H. M.; Gieser, P.; Salzberg, A.; Rao, B. N.; Parham, D.; Thomas, P. R.M.; Marcus, R. B.; Cantor, A.; Pick, T.; Green, D.; Neff, J.; Jenkins, J. J.

In: Medical and Pediatric Oncology, Vol. 30, No. 4, 01.01.1998, p. 201-209.

Research output: Contribution to journalArticle

Pratt, CB, Maurer, HM, Gieser, P, Salzberg, A, Rao, BN, Parham, D, Thomas, PRM, Marcus, RB, Cantor, A, Pick, T, Green, D, Neff, J & Jenkins, JJ 1998, 'Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy: A pediatric oncology group study', Medical and Pediatric Oncology, vol. 30, no. 4, pp. 201-209. https://doi.org/10.1002/(SICI)1096-911X(199804)30:4<201::AID-MPO1>3.0.CO;2-K
Pratt, C. B. ; Maurer, H. M. ; Gieser, P. ; Salzberg, A. ; Rao, B. N. ; Parham, D. ; Thomas, P. R.M. ; Marcus, R. B. ; Cantor, A. ; Pick, T. ; Green, D. ; Neff, J. ; Jenkins, J. J. / Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy : A pediatric oncology group study. In: Medical and Pediatric Oncology. 1998 ; Vol. 30, No. 4. pp. 201-209.
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abstract = "Background. The objectives of this study were to compare vincristine/actinomycin D/cyclophosphamide/adriamycin (VACA) with VACA plus imidazole carboxamide (DTIC) (VACAD) therapy in regards to complete/partial response and event free survival rates in children and adolescents with metastatic non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) or previously chemotherapy-naive recurrent NRSTS or locally persistent gross residual tumor after surgery and radiation therapy. Procedures. Between 1986 and March 1994, 75 patients entered this randomized study comparing VACA and VACAD, given at 3 week intervals. Sixty-one patients were considered eligible and received chemotherapy and radiation therapy to the primary tumor and areas of metastases. Thirty-six patients had regional unresected (Group III) disease, and 25 had metastatic disease (Group IV) at time of accession. Thirty-six patients received VACA (11 were not randomized), and 25 received VACAD. Results. With a median follow-up of greater than 4 years, overall and event- free survival for all eligible patients are 30.6{\%} and 18.4{\%}, respectively (S.E: 9.5{\%} and 6.8{\%}). There was insufficient evidence that DTIC offered any advantage to event free survival, but there was evidence for better outcome for patients in Group III disease in comparison to patients with Group IV disease, and for patients with a Grade 1 and 2 histology in comparison to Grade 3 lesions. Conclusions. Combination chemotherapy with VACA and VACAD were insufficient to prevent recurrent or progressive disease in children and adolescents with high stage NRSTS. The use of vincristine/ifosfamide/doxorubicin with cytokine support is under study.",
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T2 - A pediatric oncology group study

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AU - Maurer, H. M.

AU - Gieser, P.

AU - Salzberg, A.

AU - Rao, B. N.

AU - Parham, D.

AU - Thomas, P. R.M.

AU - Marcus, R. B.

AU - Cantor, A.

AU - Pick, T.

AU - Green, D.

AU - Neff, J.

AU - Jenkins, J. J.

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N2 - Background. The objectives of this study were to compare vincristine/actinomycin D/cyclophosphamide/adriamycin (VACA) with VACA plus imidazole carboxamide (DTIC) (VACAD) therapy in regards to complete/partial response and event free survival rates in children and adolescents with metastatic non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) or previously chemotherapy-naive recurrent NRSTS or locally persistent gross residual tumor after surgery and radiation therapy. Procedures. Between 1986 and March 1994, 75 patients entered this randomized study comparing VACA and VACAD, given at 3 week intervals. Sixty-one patients were considered eligible and received chemotherapy and radiation therapy to the primary tumor and areas of metastases. Thirty-six patients had regional unresected (Group III) disease, and 25 had metastatic disease (Group IV) at time of accession. Thirty-six patients received VACA (11 were not randomized), and 25 received VACAD. Results. With a median follow-up of greater than 4 years, overall and event- free survival for all eligible patients are 30.6% and 18.4%, respectively (S.E: 9.5% and 6.8%). There was insufficient evidence that DTIC offered any advantage to event free survival, but there was evidence for better outcome for patients in Group III disease in comparison to patients with Group IV disease, and for patients with a Grade 1 and 2 histology in comparison to Grade 3 lesions. Conclusions. Combination chemotherapy with VACA and VACAD were insufficient to prevent recurrent or progressive disease in children and adolescents with high stage NRSTS. The use of vincristine/ifosfamide/doxorubicin with cytokine support is under study.

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