We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) in pediatric and young adult patients: Results from a prospective study using limited-margin radiotherapy.
- Authors
Tinkle, Christopher L.; Fernandez‐Pineda, Israel; Sykes, April; Lu, Zhaohua; Hua, Chia‐ho; Neel, Michael D.; Bahrami, Armita; Shulkin, Barry L.; Kaste, Sue C.; Pappo, Alberto; Spunt, Sheri L.; Krasin, Matthew J.; Fernandez-Pineda, Israel; Hua, Chia-Ho
- Abstract
<bold>Background: </bold>Indications for and delivery of adjuvant therapies for pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) have been derived largely from adult studies; therefore, significant concern remains regarding radiation exposure to normal tissue. The authors report long-term treatment outcomes and toxicities for pediatric and young adult patients with high-grade NRSTS who were treated on a prospective trial using limited-margin radiotherapy.<bold>Methods: </bold>Sixty-two patients (ages 3-22 years) with predominantly high-grade NRSTS requiring radiation were treated on a phase 2 institutional study of conformal external-beam radiotherapy and/or brachytherapy using a 1.5-cm to 2-cm anatomically constrained margin. The estimated cumulative incidence of local failure, Gray's method estimated cumulative incidence of local failure, Kaplan-Meier method estimated survival, competing-risk regression model determined predictors of disease outcome, and toxicity was reported according to CTCAE v2.0.<bold>Results: </bold>At a median follow-up of 5.1 years (range, 0.2-10.9 years), 9 patients had experienced local failure. The 5-year overall cumulative incidence of local failure was 14.8% (95% confidence interval [CI], 7.2%-25%), and all but 1 local failure occurred outside the highest-dose irradiation volume. The 5-year Kaplan-Meier estimates for event-free and overall survival were 49.3% (95% CI, 36.3%-61.1%) and 67.9% (95% CI, 54.2%-78.3%), respectively. Multivariable analysis indicated that younger age was the only independent predictor of local recurrence (P = .004). The 5-year cumulative incidence of grade 3 or 4 late toxicity was 15% (95% CI, 7.2%-25.3%).<bold>Conclusions: </bold>The delivery of limited-margin radiotherapy using conformal external-beam radiotherapy or brachytherapy provides a high rate of local tumor control without an increase in marginal failures and with acceptable treatment-related morbidity. Cancer 2017;123:4419-29. © 2017 American Cancer Society.
- Subjects
RHABDOMYOSARCOMA; CANCER radiotherapy; RADIOISOTOPE brachytherapy; SURVIVAL analysis (Biometry); CANCER relapse; HEALTH of young adults; THERAPEUTICS; AGE factors in disease; CLINICAL trials; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; RADIOTHERAPY; RESEARCH; SARCOMA; EVALUATION research
- Publication
Cancer (0008543X), 2017, Vol 123, Issue 22, p4419
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.30793