Assessment of Response to Induction Therapy and Its Influence on 5-Year Failure-Free Survival in Group III Rhabdomyosarcoma: The Intergroup Rhabdomyosarcoma Study-IV Experience—A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group

Author:

Burke Megan1,Anderson James R.1,Kao Simon C.1,Rodeberg David1,Qualman Stephen J.1,Wolden Suzanne L.1,Meyer William H.1,Breitfeld Philip P.1

Affiliation:

1. From the Children's Hospital Cleveland Clinic, Cleveland; Children's Hospital, Columbus, OH; University of Nebraska Medical Center, Omaha, NE; University of Iowa College of Medicine, Iowa City, IA; Children's Hospital, Pittsburgh, PA; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Oklahoma Medical Science Center, Oklahoma City, OK; Duke University Medical Center; EMD Pharmaceuticals Inc, Durham, NC; and the Children's Oncology Group, Arcadia, CA

Abstract

Purpose Initial response to induction chemotherapy predicts failure-free survival (FFS) in osteosarcoma and Ewing's sarcoma. For Intergroup Rhabdomyosarcoma Study (IRS) IV patients with group III rhabdomyosarcoma, we assessed whether reported response assessed by anatomic imaging at week 8 predicted FFS. Patients and Methods We studied 444 group III patients who received induction therapy, had response assessed at week 8 by anatomic imaging, and continued with protocol therapy. Induction chemotherapy was generally followed by radiation therapy (RT) starting after week 9. Response to induction therapy was determined at weeks 0 and 8. Local institutions coded response. Results Response rate for the entire cohort at week 8 was 77% (95% CI, 73% to 81%; complete response [CR], 21%; partial response [PR], 56%) but response had no influence on FFS (P = .57). Two hundred seventy-two patients received standard-timing RT at week 9 and thus only chemotherapy during induction. Response rate was 81% (95% CI, 76% to 86%; CR, 22%; PR, 59%). In these patients, response did not influence FFS except for those with alveolar histology. One hundred thirty-two other patients received chemotherapy and RT during induction (up-front RT). Response rate was 65% (95% CI, 57% to 73%; CR, 12%; PR, 53%), but response had no influence on FFS (P = .69). Forty patients received no RT at all (protocol violation) and response to induction therapy had no effect on FFS. Conclusion In IRS-IV, response rate to induction therapy was 77% in group III patients, was independent of histology, and had no influence on FFS overall.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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