Abha A Gupta1, Yueh-Yun Chi2, James R Anderson3, Elizabeth Lyden4, Brenda Weigel5, Carola Arndt6, William H Meyer7, Abby Rosenberg8, Douglas S Hawkins8. 1. Department of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. 2. Department of Biostatistics, University of Florida, Gainesville, Florida. 3. Frontier Science and Technology Research Foundation, Madison, Wisconsin. 4. Preventive and Societal Medicine, Nebraska Medical Center, Omaha, Nebraska. 5. Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, Minnesota. 6. Mayo Clinic, Rochester, Minnesota. 7. Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. 8. Division of Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Abstract
BACKGROUND: We sought to determine whether adolescents with metastatic alveolar rhabdomyosarcoma (ARMS) or embryonal RMS (ERMS) had a different event-free survival (EFS) compared with younger patients, and to identify treatment-related factors (adverse events, AEs) that may be associated with differences in outcome. METHODS: The prevalence of AEs in adolescents older than 13 years was compared with that in patients less than or equal to 13 years of age (Fisher exact test) in patients enrolled onto ARST0431. EFS by age and histology was compared by log-rank test. RESULTS: Of 109 patients, 60 (55%) were older than 13 years; they were more likely to have nausea (17 vs. 4%, P = 0.06) and pain (20 vs. 6%, P = 0.05) compared with younger patients. Adolescents were less likely to complete therapy (63 vs. 76%) and more likely to have unplanned dose modifications outside of protocol guidelines (23 vs. 2.7%). The 3-year EFS was 26% (95% confidence interval [CI]: 15-38) for adolescents compared with 46% (95% CI: 32-60) for those less than or equal to 13 years (P = 0.011). Forty-two (59%) adolescents with ARMS had a 3-year EFS of 13% (95% CI: 2-23) compared with 30% (95% CI: 10-51) for those less than or equal to 13 years (P = 0.032). EFS was comparable between older and younger patients with ERMS (64 vs. 55%, P = 0.53). CONCLUSIONS: Although there was a significant difference in EFS and protocol compliance by age, the differences in age-related toxicity are unlikely to account for this. Observed differences in pain and nausea by age could be real or be dependent on patient reporting of symptoms. Future studies in RMS should include patient-reported outcomes to better evaluate health-related quality of life.
BACKGROUND: We sought to determine whether adolescents with metastatic alveolar rhabdomyosarcoma (ARMS) or embryonal RMS (ERMS) had a different event-free survival (EFS) compared with younger patients, and to identify treatment-related factors (adverse events, AEs) that may be associated with differences in outcome. METHODS: The prevalence of AEs in adolescents older than 13 years was compared with that in patients less than or equal to 13 years of age (Fisher exact test) in patients enrolled onto ARST0431. EFS by age and histology was compared by log-rank test. RESULTS: Of 109 patients, 60 (55%) were older than 13 years; they were more likely to have nausea (17 vs. 4%, P = 0.06) and pain (20 vs. 6%, P = 0.05) compared with younger patients. Adolescents were less likely to complete therapy (63 vs. 76%) and more likely to have unplanned dose modifications outside of protocol guidelines (23 vs. 2.7%). The 3-year EFS was 26% (95% confidence interval [CI]: 15-38) for adolescents compared with 46% (95% CI: 32-60) for those less than or equal to 13 years (P = 0.011). Forty-two (59%) adolescents with ARMS had a 3-year EFS of 13% (95% CI: 2-23) compared with 30% (95% CI: 10-51) for those less than or equal to 13 years (P = 0.032). EFS was comparable between older and younger patients with ERMS (64 vs. 55%, P = 0.53). CONCLUSIONS: Although there was a significant difference in EFS and protocol compliance by age, the differences in age-related toxicity are unlikely to account for this. Observed differences in pain and nausea by age could be real or be dependent on patient reporting of symptoms. Future studies in RMS should include patient-reported outcomes to better evaluate health-related quality of life.
Authors: Ashley Wilder Smith; Keith M Bellizzi; Theresa H M Keegan; Brad Zebrack; Vivien W Chen; Anne Victoria Neale; Ann S Hamilton; Margarett Shnorhavorian; Charles F Lynch Journal: J Clin Oncol Date: 2013-05-06 Impact factor: 44.544
Authors: Ethan Basch; Amy P Abernethy; C Daniel Mullins; Bryce B Reeve; Mary Lou Smith; Stephen Joel Coons; Jeff Sloan; Keith Wenzel; Cynthia Chauhan; Wayland Eppard; Elizabeth S Frank; Joseph Lipscomb; Stephen A Raymond; Merianne Spencer; Sean Tunis Journal: J Clin Oncol Date: 2012-10-15 Impact factor: 44.544
Authors: H M Maurer; E A Gehan; M Beltangady; W Crist; P S Dickman; S S Donaldson; C Fryer; D Hammond; D M Hays; J Herrmann Journal: Cancer Date: 1993-03-01 Impact factor: 6.860
Authors: H M Maurer; M Beltangady; E A Gehan; W Crist; D Hammond; D M Hays; R Heyn; W Lawrence; W Newton; J Ortega Journal: Cancer Date: 1988-01-15 Impact factor: 6.860
Authors: Odile Oberlin; Annie Rey; Elizabeth Lyden; Gianni Bisogno; Michael C G Stevens; William H Meyer; Modesto Carli; James R Anderson Journal: J Clin Oncol Date: 2008-05-10 Impact factor: 44.544
Authors: Brenda J Weigel; Elizabeth Lyden; James R Anderson; William H Meyer; David M Parham; David A Rodeberg; Jeff M Michalski; Douglas S Hawkins; Carola A S Arndt Journal: J Clin Oncol Date: 2015-10-26 Impact factor: 44.544
Authors: R Peto; M C Pike; P Armitage; N E Breslow; D R Cox; S V Howard; N Mantel; K McPherson; J Peto; P G Smith Journal: Br J Cancer Date: 1977-01 Impact factor: 7.640
Authors: Elysia M Alvarez; Marcio Malogolowkin; Jeffrey S Hoch; Qian Li; Ann Brunson; Brad H Pollock; Lori Muffly; Ted Wun; Theresa H M Keegan Journal: JCO Oncol Pract Date: 2020-06-11
Authors: Kee Kiat Yeo; Darcy E Burgers; Katelynn Brodigan; Karen Fasciano; A Lindsay Frazier; Katherine E Warren; David A Reardon Journal: Neurooncol Pract Date: 2021-02-18
Authors: Leonie D H Gossel; Catrin Heim; Lisa-Marie Pfeffermann; Laura M Moser; Halvard B Bönig; Thomas E Klingebiel; Peter Bader; Winfried S Wels; Michael Merker; Eva Rettinger Journal: Cancers (Basel) Date: 2021-03-22 Impact factor: 6.639