Predicting Outcome in Patients with Rhabdomyosarcoma: Role of [18F]Fluorodeoxyglucose Positron Emission Tomography

Casey, Dana L.; Wexler, Leonard H.; Fox, Josef J.; Dharmarajan, Kavita V.; Schöder, Heiko; Price, Alison N.; Wolden, Suzanne L.

doi:10.1016/j.ijrobp.2014.08.005

Cited by 65 publications

(45 citation statements)

References 28 publications

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“…A more promising direction of investigation may be the relationship between functional response assessed by positron emission tomography scan and local control. A strong correlation has been reported in a series of patients from Memorial Sloan-Kettering Cancer Center, but this finding requires validation in a larger, prospective protocol (13). …”

Section: Discussionmentioning

confidence: 83%

Local Control for Intermediate-Risk Rhabdomyosarcoma: Results From D9803 According to Histology, Group, Site, and Size: A Report From the Children's Oncology Group

Wolden

Lyden

Arndt

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Purpose To determine local control according to clinical variables for patients with intermediate-risk rhabdomyosarcoma (RMS) treated on Children’s Oncology Group protocol D9803. Patients and Methods Of 702 patients enrolled, we analyzed 423 patients with central pathology–confirmed group III embryonal (n = 280) or alveolar (group III, n = 102; group I–II, n = 41) RMS. Median age was 5 years. Patients received 42 weeks of VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VTC (T = topotecan). Local therapy with 50.4 Gy radiation therapy with or without delayed primary excision began at week 12 for group III patients. Patients with group I/II alveolar RMS received 36–41.4 Gy. Local failure (LF) was defined as local progression as a first event with or without concurrent regional or distant failure. Results At a median follow-up of 6.6 years, patients with clinical group I/II alveolar RMS had a 5-year event-free survival rate of 69% and LF of 10%. Among patients with group III RMS, 5-year event-free survival and LF rates were 70% and 19%, respectively. Local failure rates did not differ by histology, nodal status, or primary site, though there was a trend for increased LF for retroperitoneal (RP) tumors (P = .12). Tumors ≥5 cm were more likely to fail locally than tumors <5 cm (25% vs 10%, P = .0004). Almost all (98%) RP tumors were ≥5 cm, with no difference in LF by site when the analysis was restricted to tumors ≥5 cm (P = .86). Conclusion Local control was excellent for clinical group I/II alveolar RMS. Local failure constituted 63% of initial events in clinical group III patients and did not vary by histology or nodal status. The trend for higher LF in RP tumors was related to tumor size. There has been no clear change in local control over RMS studies, including IRS-III and IRS-IV. Novel approaches are warranted for larger tumors (≥5 cm).

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Section: Discussionmentioning

confidence: 83%

Local Control for Intermediate-Risk Rhabdomyosarcoma: Results From D9803 According to Histology, Group, Site, and Size: A Report From the Children's Oncology Group

Wolden

Lyden

Arndt

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…8,12,24,25 Therefore, we advocate that future phase 3 trials focus on the efficacy of functional imaging techniques, such as diffusion-weighted magnetic resonance imaging and fludeoxyglucose positron emission tomography, to determine early response, although preliminary results are conflicting. 20,[26][27][28][29] Furthermore, for consistency and standardization of response measurements and subsequent treatment decisions, we emphasize the importance of the use of standardized imaging protocols and central radiology review as part of future trials.…”

Section: Early Response In Rhabdomyosarcoma/vaarwerk Et Almentioning

confidence: 99%

Prognostic relevance of early radiologic response to induction chemotherapy in pediatric rhabdomyosarcoma: A report from the International Society of Pediatric Oncology Malignant Mesenchymal Tumor 95 study

Vaarwerk

Lee

Breunis

et al. 2017

Cancer

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“…Residual masses that remain PET avid are a challenge to manage. These patients have an increased risk of both local and metastatic relapse, and a decision whether to biopsy or resect a residual PET avid tumor should be made on a case‐by‐case basis weighing the risks of morbidity versus benefit …”

Section: Questionsmentioning

confidence: 99%

“…These patients have an increased risk of both local and metastatic relapse, and a decision whether to biopsy or resect a residual PET avid tumor should be made on a case-by-case basis weighing the risks of morbidity versus benefit. 42 Given the poor outcome for high-risk RMS patients, maintenance chemotherapy regimens have been tested in a small nonrandomized clinical trial but no conclusive benefit has been established. 43 We therefore do not generally recommend maintenance chemotherapy in RMS patients, except in the context of a clinical trial.…”

Section: Question 8: How Should Patients With Residual Masses At the mentioning

confidence: 99%

Consensus and controversies regarding the treatment of rhabdomyosarcoma

Borinstein

Steppan

Hayashi

et al. 2017

Pediatric Blood & Cancer

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Optimal treatment of rhabdomyosarcoma (RMS) requires multidisciplinary approach, incorporating chemotherapy with local control. Although current therapies are built on cooperative group trials, a comprehensive standard of care to guide clinical decision making has been lacking, especially for relapsed patients. Therefore, we assembled a panel of pediatric and adolescent and young adult sarcoma experts to develop treatment guidelines for managing RMS and to identify areas in which further research is needed. We created algorithms incorporating evidence-based care for patients with RMS, emphasizing the importance of clinical trials and close integration of all specialties involved in the care of these patients.

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Predicting Outcome in Patients with Rhabdomyosarcoma: Role of [18F]Fluorodeoxyglucose Positron Emission Tomography

Cited by 65 publications

References 28 publications

Local Control for Intermediate-Risk Rhabdomyosarcoma: Results From D9803 According to Histology, Group, Site, and Size: A Report From the Children's Oncology Group

Local Control for Intermediate-Risk Rhabdomyosarcoma: Results From D9803 According to Histology, Group, Site, and Size: A Report From the Children's Oncology Group

Prognostic relevance of early radiologic response to induction chemotherapy in pediatric rhabdomyosarcoma: A report from the International Society of Pediatric Oncology Malignant Mesenchymal Tumor 95 study

Consensus and controversies regarding the treatment of rhabdomyosarcoma

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