Local therapy to distant metastatic sites in stage IV rhabdomyosarcoma

Arvind C. Mohan; Rajkumar Venkatramani; M. Fatih Okcu; Jed G. Nuchtern; Sanjeev A. Vasudevan; Anita Mahajan; Nino C. Rainusso; Wendy Allen-Rhoades; Murali Chintagumpala; Arnold C. Paulino

doi:10.1002/pbc.26859

Local therapy to distant metastatic sites in stage IV rhabdomyosarcoma

Arvind C. Mohan, Rajkumar Venkatramani, M. Fatih Okcu, Jed G. Nuchtern, Sanjeev A. Vasudevan, Anita Mahajan, Nino C. Rainusso, Wendy Allen-Rhoades, Murali Chintagumpala, Arnold C. Paulino

Houston Methodist

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

PURPOSE: To determine the impact of surgery and/or radiation therapy on distant metastatic sites (DMS) in children with stage IV rhabdomyosarcoma (RMS).

METHODS: A retrospective chart review was conducted on all patients with stage IV RMS at Texas Children's Hospital from 1992 to 2012. Data analyzed included age, gender, primary site, histologic subtype, number and sites of metastases, treatment including local therapy to DMS, and Oberlin score.

RESULTS: The 5-year progression-free survival (PFS) and overall survival (OS) rates were 20% and 25%. The 5-year PFS in patients receiving local therapy to all DMS (n = 16) and to less than all DMS (n = 19) was 31.3% versus 0% (P = 0.002), whereas the 5-year OS was 37.3% versus 0% (P < 0.001), respectively. The 5-year PFS in patients with isolated lung metastasis versus other types of metastasis was 29% versus 7% (P = n.s.), whereas the 5-year OS was 43% versus 10% (P = 0.01). The 5-year pulmonary local control was improved by the use of whole lung irradiation (WLI; 56% vs. 10%, P = 0.03).

CONCLUSIONS: Local treatment to all metastatic sites was associated with improved PFS and OS at 5 years. The use of WLI improved pulmonary control in patients with lung metastasis. We recommend an aggressive approach including local therapy to DMS in children with stage IV RMS.

Original language	English (US)
Article number	e26859
Journal	Pediatric Blood and Cancer
Volume	65
Issue number	2
DOIs	https://doi.org/10.1002/pbc.26859
State	Published - Feb 1 2018

Keywords

local control
metastasis
radiotherapy
rhabdomyosarcoma
whole lung irradiation
Humans
Child, Preschool
Infant
Male
Survival Rate
Rhabdomyosarcoma/mortality
Disease-Free Survival
Neoplasm Metastasis
Female
Lung Neoplasms/mortality
Retrospective Studies
Neoplasm Staging
Child

ASJC Scopus subject areas

Hematology
Oncology
Pediatrics, Perinatology, and Child Health

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10.1002/pbc.26859

Cite this

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title = "Local therapy to distant metastatic sites in stage IV rhabdomyosarcoma",

abstract = "PURPOSE: To determine the impact of surgery and/or radiation therapy on distant metastatic sites (DMS) in children with stage IV rhabdomyosarcoma (RMS).METHODS: A retrospective chart review was conducted on all patients with stage IV RMS at Texas Children's Hospital from 1992 to 2012. Data analyzed included age, gender, primary site, histologic subtype, number and sites of metastases, treatment including local therapy to DMS, and Oberlin score.RESULTS: The 5-year progression-free survival (PFS) and overall survival (OS) rates were 20% and 25%. The 5-year PFS in patients receiving local therapy to all DMS (n = 16) and to less than all DMS (n = 19) was 31.3% versus 0% (P = 0.002), whereas the 5-year OS was 37.3% versus 0% (P < 0.001), respectively. The 5-year PFS in patients with isolated lung metastasis versus other types of metastasis was 29% versus 7% (P = n.s.), whereas the 5-year OS was 43% versus 10% (P = 0.01). The 5-year pulmonary local control was improved by the use of whole lung irradiation (WLI; 56% vs. 10%, P = 0.03).CONCLUSIONS: Local treatment to all metastatic sites was associated with improved PFS and OS at 5 years. The use of WLI improved pulmonary control in patients with lung metastasis. We recommend an aggressive approach including local therapy to DMS in children with stage IV RMS.",

keywords = "local control, metastasis, radiotherapy, rhabdomyosarcoma, whole lung irradiation, Humans, Child, Preschool, Infant, Male, Survival Rate, Rhabdomyosarcoma/mortality, Disease-Free Survival, Neoplasm Metastasis, Female, Lung Neoplasms/mortality, Retrospective Studies, Neoplasm Staging, Child",

author = "Mohan, {Arvind C.} and Rajkumar Venkatramani and Okcu, {M. Fatih} and Nuchtern, {Jed G.} and Vasudevan, {Sanjeev A.} and Anita Mahajan and Rainusso, {Nino C.} and Wendy Allen-Rhoades and Murali Chintagumpala and Paulino, {Arnold C.}",

year = "2018",

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day = "1",

doi = "10.1002/pbc.26859",

language = "English (US)",

volume = "65",

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TY - JOUR

T1 - Local therapy to distant metastatic sites in stage IV rhabdomyosarcoma

AU - Mohan, Arvind C.

AU - Venkatramani, Rajkumar

AU - Okcu, M. Fatih

AU - Nuchtern, Jed G.

AU - Vasudevan, Sanjeev A.

AU - Mahajan, Anita

AU - Rainusso, Nino C.

AU - Allen-Rhoades, Wendy

AU - Chintagumpala, Murali

AU - Paulino, Arnold C.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - PURPOSE: To determine the impact of surgery and/or radiation therapy on distant metastatic sites (DMS) in children with stage IV rhabdomyosarcoma (RMS).METHODS: A retrospective chart review was conducted on all patients with stage IV RMS at Texas Children's Hospital from 1992 to 2012. Data analyzed included age, gender, primary site, histologic subtype, number and sites of metastases, treatment including local therapy to DMS, and Oberlin score.RESULTS: The 5-year progression-free survival (PFS) and overall survival (OS) rates were 20% and 25%. The 5-year PFS in patients receiving local therapy to all DMS (n = 16) and to less than all DMS (n = 19) was 31.3% versus 0% (P = 0.002), whereas the 5-year OS was 37.3% versus 0% (P < 0.001), respectively. The 5-year PFS in patients with isolated lung metastasis versus other types of metastasis was 29% versus 7% (P = n.s.), whereas the 5-year OS was 43% versus 10% (P = 0.01). The 5-year pulmonary local control was improved by the use of whole lung irradiation (WLI; 56% vs. 10%, P = 0.03).CONCLUSIONS: Local treatment to all metastatic sites was associated with improved PFS and OS at 5 years. The use of WLI improved pulmonary control in patients with lung metastasis. We recommend an aggressive approach including local therapy to DMS in children with stage IV RMS.

AB - PURPOSE: To determine the impact of surgery and/or radiation therapy on distant metastatic sites (DMS) in children with stage IV rhabdomyosarcoma (RMS).METHODS: A retrospective chart review was conducted on all patients with stage IV RMS at Texas Children's Hospital from 1992 to 2012. Data analyzed included age, gender, primary site, histologic subtype, number and sites of metastases, treatment including local therapy to DMS, and Oberlin score.RESULTS: The 5-year progression-free survival (PFS) and overall survival (OS) rates were 20% and 25%. The 5-year PFS in patients receiving local therapy to all DMS (n = 16) and to less than all DMS (n = 19) was 31.3% versus 0% (P = 0.002), whereas the 5-year OS was 37.3% versus 0% (P < 0.001), respectively. The 5-year PFS in patients with isolated lung metastasis versus other types of metastasis was 29% versus 7% (P = n.s.), whereas the 5-year OS was 43% versus 10% (P = 0.01). The 5-year pulmonary local control was improved by the use of whole lung irradiation (WLI; 56% vs. 10%, P = 0.03).CONCLUSIONS: Local treatment to all metastatic sites was associated with improved PFS and OS at 5 years. The use of WLI improved pulmonary control in patients with lung metastasis. We recommend an aggressive approach including local therapy to DMS in children with stage IV RMS.

KW - local control

KW - metastasis

KW - radiotherapy

KW - rhabdomyosarcoma

KW - whole lung irradiation

KW - Humans

KW - Child, Preschool

KW - Infant

KW - Male

KW - Survival Rate

KW - Rhabdomyosarcoma/mortality

KW - Disease-Free Survival

KW - Neoplasm Metastasis

KW - Female

KW - Lung Neoplasms/mortality

KW - Retrospective Studies

KW - Neoplasm Staging

KW - Child

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DO - 10.1002/pbc.26859

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C2 - 29049857

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JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

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M1 - e26859

ER -

Local therapy to distant metastatic sites in stage IV rhabdomyosarcoma

Abstract

Keywords

ASJC Scopus subject areas

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