Christopher L Tinkle1, Jason Lu1, Yuanyuan Han2, Yimei Li2, Beth M McCarville3, Michael D Neel4, Michael W Bishop5, Matthew J Krasin1. 1. Departments of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. 2. Departments of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee. 3. Departments of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee. 4. Departments of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee. 5. Departments of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Abstract
BACKGROUND: Radiation therapy (RT) confers local tumor control and survival advantages in some patients with osteosarcoma, yet pediatric and adolescent and young adult (AYA) population studies are limited. METHODS: Twenty-eight patients treated with curative-intent RT (median dose, 59.4 Gy; range, 40-76 Gy) at our institution from 1990 to 2017 were retrospectively identified. Cumulative incidence (CIN) of local failure (LF) was estimated by Gray's method and overall survival (OS) by the Kaplan-Meier method. Competing-risk regression and Cox proportional hazards models determined predictors of outcome. Toxicity was reported according to CTCAE v4.0. RESULTS: With a median follow-up of 99.1 months in living patients, nine patients (32.1%) developed LF. Estimated CINs of LF with competing risk of death at 5 years for the entire cohort, patients at initial diagnosis (n = 16), and recurrent/refractory patients (n = 12) were 32.7% (95% CI, 16.0-50.5%), 25.0% (95% CI, 7.3-48.0%), and 43.8% (95% CI, 13.6-71.0%), respectively (P = 0.31). Estimated 5-year OS was 42.6% (95% CI, 23.2-62.0%), 54.6% (95% CI, 29.5-79.6%), and 24.3% (95% CI, 0-52.2%), respectively (P = 0.15). No clinicopathologic features were significantly associated with LF, yet lack of chemotherapy or metastasis at the time of RT was independent significant prognostic factors of decreased OS. Eleven patients experienced RT-related morbidity, with two grade 3 toxicities and no grade 4/5 events. CONCLUSIONS: Curative-intent RT in pediatric and AYA patients was well tolerated and achieved a local tumor control rate of 75% in patients with primary disease. Local control rates were similar to those in primarily adult studies, with similar or lower doses.
BACKGROUND: Radiation therapy (RT) confers local tumor control and survival advantages in some patients with osteosarcoma, yet pediatric and adolescent and young adult (AYA) population studies are limited. METHODS: Twenty-eight patients treated with curative-intent RT (median dose, 59.4 Gy; range, 40-76 Gy) at our institution from 1990 to 2017 were retrospectively identified. Cumulative incidence (CIN) of local failure (LF) was estimated by Gray's method and overall survival (OS) by the Kaplan-Meier method. Competing-risk regression and Cox proportional hazards models determined predictors of outcome. Toxicity was reported according to CTCAE v4.0. RESULTS: With a median follow-up of 99.1 months in living patients, nine patients (32.1%) developed LF. Estimated CINs of LF with competing risk of death at 5 years for the entire cohort, patients at initial diagnosis (n = 16), and recurrent/refractory patients (n = 12) were 32.7% (95% CI, 16.0-50.5%), 25.0% (95% CI, 7.3-48.0%), and 43.8% (95% CI, 13.6-71.0%), respectively (P = 0.31). Estimated 5-year OS was 42.6% (95% CI, 23.2-62.0%), 54.6% (95% CI, 29.5-79.6%), and 24.3% (95% CI, 0-52.2%), respectively (P = 0.15). No clinicopathologic features were significantly associated with LF, yet lack of chemotherapy or metastasis at the time of RT was independent significant prognostic factors of decreased OS. Eleven patients experienced RT-related morbidity, with two grade 3 toxicities and no grade 4/5 events. CONCLUSIONS: Curative-intent RT in pediatric and AYApatients was well tolerated and achieved a local tumor control rate of 75% in patients with primary disease. Local control rates were similar to those in primarily adult studies, with similar or lower doses.
Authors: Douglas J Harrison; David S Geller; Jonathan D Gill; Valerae O Lewis; Richard Gorlick Journal: Expert Rev Anticancer Ther Date: 2017-12-14 Impact factor: 4.512
Authors: Najat C Daw; Michael D Neel; Bhaskar N Rao; Catherine A Billups; Jianrong Wu; Jesse J Jenkins; Juan Quintana; Lori Luchtman-Jones; Milena Villarroel; Victor M Santana Journal: Cancer Date: 2011-01-10 Impact factor: 6.860
Authors: Thomas F DeLaney; Lily Park; Saveli I Goldberg; Eugen B Hug; Norbert J Liebsch; John E Munzenrider; Herman D Suit Journal: Int J Radiat Oncol Biol Phys Date: 2005-02-01 Impact factor: 7.038
Authors: W H Meyer; C B Pratt; C A Poquette; B N Rao; D M Parham; N M Marina; A S Pappo; H H Mahmoud; J J Jenkins; J Harper; M Neel; B D Fletcher Journal: J Clin Oncol Date: 2001-01-01 Impact factor: 44.544
Authors: Milcah C Scott; Aaron L Sarver; Katherine J Gavin; Venugopal Thayanithy; David M Getzy; Robert A Newman; Gary R Cutter; Kerstin Lindblad-Toh; William C Kisseberth; Lawrence E Hunter; Subbaya Subramanian; Matthew Breen; Jaime F Modiano Journal: Bone Date: 2011-05-15 Impact factor: 4.398