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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

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