Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults.

Tobias M Dantonello; Christoph Int-Veen; Dieter Harms; Ivo Leuschner; Bernhard F Schmidt; Manfred Herbst; Heribert Juergens; Hans-Gerhard Scheel-Walter; Stefan S Bielack; Thomas Klingebiel; Roswitha Dickerhoff; Sylvia Kirsch; Ines Brecht; Rainer Schmelzle; Michael Greulich; Helmut Gadner; Jeanette Greiner; Ildiko Marky; Joern Treuner; Ewa Koscielniak

Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults.

Standard

Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults. / Dantonello, Tobias M; Int-Veen, Christoph; Harms, Dieter; Leuschner, Ivo; Schmidt, Bernhard F; Herbst, Manfred; Juergens, Heribert; Scheel-Walter, Hans-Gerhard; Bielack, Stefan S; Klingebiel, Thomas; Dickerhoff, Roswitha; Kirsch, Sylvia; Brecht, Ines; Schmelzle, Rainer; Greulich, Michael; Gadner, Helmut; Greiner, Jeanette; Marky, Ildiko; Treuner, Joern; Koscielniak, Ewa.

In: J CLIN ONCOL, Vol. 27, No. 9, 9, 2009, p. 1446-1455.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Dantonello, TM, Int-Veen, C, Harms, D, Leuschner, I, Schmidt, BF, Herbst, M, Juergens, H, Scheel-Walter, H-G, Bielack, SS, Klingebiel, T, Dickerhoff, R, Kirsch, S, Brecht, I, Schmelzle, R, Greulich, M, Gadner, H, Greiner, J, Marky, I, Treuner, J & Koscielniak, E 2009, 'Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults.', J CLIN ONCOL, vol. 27, no. 9, 9, pp. 1446-1455. <http://www.ncbi.nlm.nih.gov/pubmed/19224858?dopt=Citation>

APA

Dantonello, T. M., Int-Veen, C., Harms, D., Leuschner, I., Schmidt, B. F., Herbst, M., Juergens, H., Scheel-Walter, H-G., Bielack, S. S., Klingebiel, T., Dickerhoff, R., Kirsch, S., Brecht, I., Schmelzle, R., Greulich, M., Gadner, H., Greiner, J., Marky, I., Treuner, J., & Koscielniak, E. (2009). Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults. J CLIN ONCOL, 27(9), 1446-1455. [9]. http://www.ncbi.nlm.nih.gov/pubmed/19224858?dopt=Citation

Vancouver

Dantonello TM, Int-Veen C, Harms D, Leuschner I, Schmidt BF, Herbst M et al. Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults. J CLIN ONCOL. 2009;27(9):1446-1455. 9.

Bibtex

@article{8108993dc0ce4f28aba84986a38e93b0,

title = "Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults.",

abstract = "PURPOSE: To improve risk-adapted therapy for localized childhood soft tissue sarcoma within an international multicenter setting. PATIENTS AND METHODS: Four hundred forty-one patients younger than 21 years with localized rhabdomyosarcoma and rhabdomyosarcoma-like tumors (ie, extraosseous tumors of the Ewing family, synovial sarcoma, and undifferentiated sarcoma) were eligible. Therapy was stratified according to postsurgical stage, histology, and tumor site. In unresectable tumors, treatment was further adapted depending on response to induction chemotherapy, TN classification, tumor size and second-look surgery. A novel five-drug combination of etoposide, vincristine, dactinomycin, ifosfamide, and doxorubicin (EVAIA) was evaluated for high-risk patients, but cumulative chemotherapy dosage and treatment duration were reduced for the remaining individuals as compared with that of the previous trial CWS-86. Hyperfractionated accelerated radiotherapy (HART) was recommended at doses of either 32 or 48 Gy. RESULTS: At a median follow-up of 8 years, 5-year event-free survival (EFS) and overall (OS) survival for the entire cohort was 63% +/- 4% and 73% +/- 4%, respectively (all survival rates in this abstract are calculated and displayed with +/-95% CI). EFS/OS rates by histology were 60% +/- 5%/72% +/- 5% in rhabdomyosarcoma, 62% +/- 10%/69% +/- 10% for Ewing tumors of soft tissues, 84% +/- 12%/90% +/- 10% for synovial sarcoma, and 67% +/- 38%/83% +/- 30% for undifferentiated sarcoma, respectively. Response to one cycle of the five-drug combination EVAIA was similar to that of the four-drug combination VAIA used in CWS-86. Two hundred twelve patients with rhabdomyosarcoma underwent radiation (EFS, 66% +/- 6%); 53 of those patients had a favorable risk profile and received 32 Gy of HART (EFS, 73% +/- 12%). TN classification, tumor site, tumor size, histology, and age were prognostic in univariate analysis. CONCLUSION: Improved risk stratification enabled decreased therapy intensity for selected patients without compromising survival. Intensified chemotherapy with EVAIA did not improve outcome of localized high-risk rhabdomyosarcoma.",

keywords = "Adult, Humans, Male, Female, Adolescent, Young Adult, dosage, Child, Combined Modality Therapy, Child, Preschool, Infant, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Dactinomycin administration, Dose Fractionation, Doxorubicin administration, Etoposide administration, Ifosfamide administration, Infant, Newborn, Rhabdomyosarcoma therapy, Sarcoma therapy, Sarcoma, Ewing's therapy, Sarcoma, Synovial therapy, Soft Tissue Neoplasms therapy, Vincristine administration, Adult, Humans, Male, Female, Adolescent, Young Adult, dosage, Child, Combined Modality Therapy, Child, Preschool, Infant, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Dactinomycin administration, Dose Fractionation, Doxorubicin administration, Etoposide administration, Ifosfamide administration, Infant, Newborn, Rhabdomyosarcoma therapy, Sarcoma therapy, Sarcoma, Ewing's therapy, Sarcoma, Synovial therapy, Soft Tissue Neoplasms therapy, Vincristine administration",

author = "Dantonello, {Tobias M} and Christoph Int-Veen and Dieter Harms and Ivo Leuschner and Schmidt, {Bernhard F} and Manfred Herbst and Heribert Juergens and Hans-Gerhard Scheel-Walter and Bielack, {Stefan S} and Thomas Klingebiel and Roswitha Dickerhoff and Sylvia Kirsch and Ines Brecht and Rainer Schmelzle and Michael Greulich and Helmut Gadner and Jeanette Greiner and Ildiko Marky and Joern Treuner and Ewa Koscielniak",

year = "2009",

language = "Deutsch",

volume = "27",

pages = "1446--1455",

journal = "J CLIN ONCOL",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

number = "9",

}

RIS

TY - JOUR

T1 - Cooperative trial CWS-91 for localized soft tissue sarcoma in children, adolescents, and young adults.

AU - Dantonello, Tobias M

AU - Int-Veen, Christoph

AU - Harms, Dieter

AU - Leuschner, Ivo

AU - Schmidt, Bernhard F

AU - Herbst, Manfred

AU - Juergens, Heribert

AU - Scheel-Walter, Hans-Gerhard

AU - Bielack, Stefan S

AU - Klingebiel, Thomas

AU - Dickerhoff, Roswitha

AU - Kirsch, Sylvia

AU - Brecht, Ines

AU - Schmelzle, Rainer

AU - Greulich, Michael

AU - Gadner, Helmut

AU - Greiner, Jeanette

AU - Marky, Ildiko

AU - Treuner, Joern

AU - Koscielniak, Ewa

PY - 2009

Y1 - 2009

N2 - PURPOSE: To improve risk-adapted therapy for localized childhood soft tissue sarcoma within an international multicenter setting. PATIENTS AND METHODS: Four hundred forty-one patients younger than 21 years with localized rhabdomyosarcoma and rhabdomyosarcoma-like tumors (ie, extraosseous tumors of the Ewing family, synovial sarcoma, and undifferentiated sarcoma) were eligible. Therapy was stratified according to postsurgical stage, histology, and tumor site. In unresectable tumors, treatment was further adapted depending on response to induction chemotherapy, TN classification, tumor size and second-look surgery. A novel five-drug combination of etoposide, vincristine, dactinomycin, ifosfamide, and doxorubicin (EVAIA) was evaluated for high-risk patients, but cumulative chemotherapy dosage and treatment duration were reduced for the remaining individuals as compared with that of the previous trial CWS-86. Hyperfractionated accelerated radiotherapy (HART) was recommended at doses of either 32 or 48 Gy. RESULTS: At a median follow-up of 8 years, 5-year event-free survival (EFS) and overall (OS) survival for the entire cohort was 63% +/- 4% and 73% +/- 4%, respectively (all survival rates in this abstract are calculated and displayed with +/-95% CI). EFS/OS rates by histology were 60% +/- 5%/72% +/- 5% in rhabdomyosarcoma, 62% +/- 10%/69% +/- 10% for Ewing tumors of soft tissues, 84% +/- 12%/90% +/- 10% for synovial sarcoma, and 67% +/- 38%/83% +/- 30% for undifferentiated sarcoma, respectively. Response to one cycle of the five-drug combination EVAIA was similar to that of the four-drug combination VAIA used in CWS-86. Two hundred twelve patients with rhabdomyosarcoma underwent radiation (EFS, 66% +/- 6%); 53 of those patients had a favorable risk profile and received 32 Gy of HART (EFS, 73% +/- 12%). TN classification, tumor site, tumor size, histology, and age were prognostic in univariate analysis. CONCLUSION: Improved risk stratification enabled decreased therapy intensity for selected patients without compromising survival. Intensified chemotherapy with EVAIA did not improve outcome of localized high-risk rhabdomyosarcoma.

AB - PURPOSE: To improve risk-adapted therapy for localized childhood soft tissue sarcoma within an international multicenter setting. PATIENTS AND METHODS: Four hundred forty-one patients younger than 21 years with localized rhabdomyosarcoma and rhabdomyosarcoma-like tumors (ie, extraosseous tumors of the Ewing family, synovial sarcoma, and undifferentiated sarcoma) were eligible. Therapy was stratified according to postsurgical stage, histology, and tumor site. In unresectable tumors, treatment was further adapted depending on response to induction chemotherapy, TN classification, tumor size and second-look surgery. A novel five-drug combination of etoposide, vincristine, dactinomycin, ifosfamide, and doxorubicin (EVAIA) was evaluated for high-risk patients, but cumulative chemotherapy dosage and treatment duration were reduced for the remaining individuals as compared with that of the previous trial CWS-86. Hyperfractionated accelerated radiotherapy (HART) was recommended at doses of either 32 or 48 Gy. RESULTS: At a median follow-up of 8 years, 5-year event-free survival (EFS) and overall (OS) survival for the entire cohort was 63% +/- 4% and 73% +/- 4%, respectively (all survival rates in this abstract are calculated and displayed with +/-95% CI). EFS/OS rates by histology were 60% +/- 5%/72% +/- 5% in rhabdomyosarcoma, 62% +/- 10%/69% +/- 10% for Ewing tumors of soft tissues, 84% +/- 12%/90% +/- 10% for synovial sarcoma, and 67% +/- 38%/83% +/- 30% for undifferentiated sarcoma, respectively. Response to one cycle of the five-drug combination EVAIA was similar to that of the four-drug combination VAIA used in CWS-86. Two hundred twelve patients with rhabdomyosarcoma underwent radiation (EFS, 66% +/- 6%); 53 of those patients had a favorable risk profile and received 32 Gy of HART (EFS, 73% +/- 12%). TN classification, tumor site, tumor size, histology, and age were prognostic in univariate analysis. CONCLUSION: Improved risk stratification enabled decreased therapy intensity for selected patients without compromising survival. Intensified chemotherapy with EVAIA did not improve outcome of localized high-risk rhabdomyosarcoma.

KW - Adult

KW - Humans

KW - Male

KW - Female

KW - Adolescent

KW - Young Adult

KW - dosage

KW - Child

KW - Combined Modality Therapy

KW - Child, Preschool

KW - Infant

KW - Antineoplastic Combined Chemotherapy Protocols therapeutic use

KW - Dactinomycin administration

KW - Dose Fractionation

KW - Doxorubicin administration

KW - Etoposide administration

KW - Ifosfamide administration

KW - Infant, Newborn

KW - Rhabdomyosarcoma therapy

KW - Sarcoma therapy

KW - Sarcoma, Ewing's therapy

KW - Sarcoma, Synovial therapy

KW - Soft Tissue Neoplasms therapy

KW - Vincristine administration