Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group.

Publication ,  Journal Article
Casey, DL; Chi, Y-Y; Donaldson, SS; Hawkins, DS; Tian, J; Arndt, CA; Rodeberg, DA; Routh, JC; Lautz, TB; Gupta, AA; Yock, TI; Wolden, SL
Published in: Cancer
September 15, 2019

BACKGROUND: The objective of this study was to evaluate local control for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children's Oncology Group (COG) protocol ARST0531. METHODS: This study analyzed 424 patients with intermediate-risk RMS. Patients were randomized to chemotherapy with either vincristine, dactinomycin, and cyclophosphamide (VAC) or VAC alternating with vincristine and irinotecan. With the goal of improving local control, radiation therapy (RT) was delivered early at week 4 and was concurrent with irinotecan in the experimental arm. Individualized local control plans for children 24 months old or younger were allowed. Local failure on ARST0531 was compared with local failure on the preceding COG intermediate-risk study, D9803. RESULTS: For patients with group I/II alveolar RMS (n = 55), the 5-year cumulative incidence of local failure was 13.4%; for group III alveolar RMS (n = 141), it was 20.2%; and for group III embryonal RMS (n = 228), it was 27.9% (P = .03). Among patients with group III disease, local failure did not differ by histology, site, nodal status, RT modality, or treatment arm. Local failure was worse for a tumor size >5 cm (32.3% vs 16.7%; P = .001). Among patients with group III embryonal RMS, local failure was higher on ARST0531 than D9803 (27.9% vs 19.4%; P = .03). After the exclusion of patients 24 months old or younger or patients who did not receive radiation, local failure remained significantly increased on ARST0531 (P = .02). After adjustments for clinical prognostic factors, event-free survival and overall survival were worse on ARST0531 (P = .004 and P = .05, respectively). CONCLUSIONS: Despite interventions designed to enhance local control, local control was inferior on ARST0531 in comparison with D9803. The reason for this is unclear, but it could be the reduced cyclophosphamide dose on ARST0531.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

September 15, 2019

Volume

125

Issue

18

Start / End Page

3242 / 3248

Location

United States

Related Subject Headings

  • Young Adult
  • Vincristine
  • Urinary Bladder Neoplasms
  • Treatment Failure
  • Risk
  • Rhabdomyosarcoma
  • Retroperitoneal Neoplasms
  • Randomized Controlled Trials as Topic
  • Radiotherapy
  • Oncology & Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Casey, D. L., Chi, Y.-Y., Donaldson, S. S., Hawkins, D. S., Tian, J., Arndt, C. A., … Wolden, S. L. (2019). Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group. Cancer, 125(18), 3242–3248. https://doi.org/10.1002/cncr.32204
Casey, Dana L., Yueh-Yun Chi, Sarah S. Donaldson, Douglas S. Hawkins, Jing Tian, Carola A. Arndt, David A. Rodeberg, et al. “Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group.Cancer 125, no. 18 (September 15, 2019): 3242–48. https://doi.org/10.1002/cncr.32204.
Casey DL, Chi Y-Y, Donaldson SS, Hawkins DS, Tian J, Arndt CA, et al. Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group. Cancer. 2019 Sep 15;125(18):3242–8.
Casey, Dana L., et al. “Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group.Cancer, vol. 125, no. 18, Sept. 2019, pp. 3242–48. Pubmed, doi:10.1002/cncr.32204.
Casey DL, Chi Y-Y, Donaldson SS, Hawkins DS, Tian J, Arndt CA, Rodeberg DA, Routh JC, Lautz TB, Gupta AA, Yock TI, Wolden SL. Increased local failure for patients with intermediate-risk rhabdomyosarcoma on ARST0531: A report from the Children's Oncology Group. Cancer. 2019 Sep 15;125(18):3242–3248.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

September 15, 2019

Volume

125

Issue

18

Start / End Page

3242 / 3248

Location

United States

Related Subject Headings

  • Young Adult
  • Vincristine
  • Urinary Bladder Neoplasms
  • Treatment Failure
  • Risk
  • Rhabdomyosarcoma
  • Retroperitoneal Neoplasms
  • Randomized Controlled Trials as Topic
  • Radiotherapy
  • Oncology & Carcinogenesis