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doi:10.22028/D291-40588
Titel: | Outcome of SIOP patients with low- or intermediate-risk Wilms tumour relapsing after initial vincristine and actinomycin-D therapy only - the SIOP 93-01 and 2001 protocols |
VerfasserIn: | Groenendijk, Alissa van Tinteren, Harm Jiang, Yilin de Krijger, Ronald R. Vujanic, Gordan M. Godzinski, Jan Rübe, Christian Schenk, Jens-Peter Morosi, Carlo Pritchard-Jones, Kathy Al-Saadi, Reem Vaidya, Sucheta J. Verschuur, Arnauld C. Ramírez-Villar, Gema L. Graf, Norbert de Camargo, Beatriz Drost, Jarno Perotti, Daniela van den Heuvel-Eibrink, Marry M. Brok, Jesper Spreafico, Filippo Mavinkurve-Groothuis, Annelies M. C. |
Sprache: | Englisch |
Titel: | European Journal of Cancer |
Bandnummer: | 163 |
Seiten: | 88-97 |
Verlag/Plattform: | Elsevier |
Erscheinungsjahr: | 2022 |
Freie Schlagwörter: | Wilms tumour Recurrence SIOP protocol Treatment outcome |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Abstract Purpose: Society of International Pediatric Oncology e Renal Tumor Study Group (SIOP-RTSG) treatment recommendations for relapsed Wilms tumour (WT) are stratified by the intensity of first-line treatment. To explore the evidence for the treatment of patients relapsing after vincristine and actinomycin-D (VA) treatment for primary WT, we retrospectively evaluated rescue treatment and survival of this patient group. Patients and methods: We included 109 patients with relapse after VA therapy (no radiotherapy) for stage I-II primary low- or intermediate-risk WT from the SIOP 93e01 and SIOP 2001 studies. Univariate Cox regression analysis was performed to study the effect of relapse treatment intensity on event-free survival (EFS) and overall survival (OS). Relapse treatment intensity was classified into vincristine, actinomycin-D, and either doxorubicin or epirubicin (VAD), and more intensive therapies (ifosfamide/carboplatin/etoposide [ICE]/ 4 drugs/ high-dose chemotherapy with haematopoietic stem cell transplantation [HD HSCT]). Results: Relapse treatment regimens included either VAD, or cyclophosphamide/carboplatin/ etoposide/doxorubicin (CyCED), or ICE backbones. Radiotherapy was administered in 62 patients and HD HSCT in 15 patients. Overall, 5-year EFS and OS after relapse were 72.3% (95% confidence interval [CI]: 64.0e81.6%) and 79.3% (95% CI: 71.5e88.0%), respectively. Patients treated with VAD did not fare worse when compared with patients treated with more intensive therapies (hazard ratio EFS: 0.611 [95% CI: 0.228e1.638] [p-value Z 0.327] and hazard ratio OS: 0.438 [95% CI: 0.126e1.700] [p-value Z 0.193]). Conclusion: Patients with relapsed WT after initial VA-only treatment showed no inferior EFS and OS when treated with VAD regimens compared with more intensive rescue regimens. A subset of patients relapsing after VA may benefit from less intensive rescue treatment than ICE/CyCED-based regimens and deserve to be pinpointed by identifying additional (molecular) prognostic factors in future studies. |
DOI der Erstveröffentlichung: | 10.1016/j.ejca.2021.12.014 |
URL der Erstveröffentlichung: | https://doi.org/10.1016/j.ejca.2021.12.014 |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-405886 hdl:20.500.11880/36465 http://dx.doi.org/10.22028/D291-40588 |
ISSN: | 0959-8049 |
Datum des Eintrags: | 25-Sep-2023 |
Bezeichnung des in Beziehung stehenden Objekts: | Supplementary data |
In Beziehung stehendes Objekt: | https://ars.els-cdn.com/content/image/1-s2.0-S0959804921012855-mmc1.docx |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Pädiatrie M - Radiologie |
Professur: | M - Prof. Dr. Norbert Graf M - Prof. Dr. Christian Rübe |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Dateien zu diesem Datensatz:
Datei | Beschreibung | Größe | Format | |
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1-s2.0-S0959804921012855-main.pdf | 601,12 kB | Adobe PDF | Öffnen/Anzeigen |
Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons