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Göteborgs universitets publikationer

Treatment of children with metastatic soft tissue sarcoma with oral maintenance compared to high dose chemotherapy: report of the HD CWS-96 trial.

Författare och institution:
Thomas Klingebiel (-); Joachim Boos (-); Florian Beske (-); Erika Hallmen (-); Christoph Int-Veen (-); Tobias Dantonello (-); Joern Treuner (-); Helmut Gadner (-); Ildiko Marky (Institutionen för kliniska vetenskaper, sektionen för kvinnors och barns hälsa); Bernarda Kazanowska (-); Ewa Koscielniak (-)
Publicerad i:
Pediatric blood & cancer, 50 ( 4 ) s. 739-45
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
PURPOSE: We prospectively studied the efficacy of high dose therapy (HDT) versus an oral maintenance treatment (OMT) in patients with stage IV soft tissue sarcoma (STS). PATIENTS AND METHODS: Both groups were pretreated with the CEVAIE combination consisting of carboplatin, etoposide, vincristine, actinomycin D, ifosfamide, and epirubicin. HDT consisted of a tandem cycle of thiotepa (600 mg/m(2)) plus cyclophosphamide (4,500 mg/m(2)) and melphalan (120 mg/m(2)) plus etoposide (1,800 mg/m(2)). This treatment was compared with OMT, consisting of four cycles trofosfamide (10 days 2 x 75 mg/m(2)/day) plus etoposide (10 days 2 x 25 mg/m(2)/day), and 4 cycles trofosfamide (10 days 2 x 75 mg/m(2)/day) plus idarubicin (10 days 4 x 5 mg/m(2)). Eligibility criteria were: diagnosis confirmed by reference pathology, primary stage IV, below 22 years of age, and having completed the study therapy. RESULTS: From 96 patients 45 were treated with HDT and 51 with OMT. The main risk parameters were equally distributed in both arms. After a median follow-up of 57.4 months, 11/45 (24.4%) patients in the HDT-arm and 26/51 (57.8%) patients in OMT-arm were alive. Kaplan-Meier analysis demonstrated an overall survival for the whole group of 0.27 (OMT group: 0.52, HDT group 0.27, log rank P = 0.03). The proportional hazard analysis for patients with rhabdomyosarcoma (RMS) or "RMS-like" tumors (77.1% of all patients) demonstrated an independent benefit of OMT on outcome. CONCLUSION: Oral maintenance therapy seems to be a promising option for patients with RMS-like stage IV tumors.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Medicinska grundvetenskaper ->
Immunologi inom det medicinska området ->
Klinisk medicin ->
Antineoplastic Combined Chemotherapy Protocols, therapeutic use, Carboplatin, administration & dosage, Child, Child, Preschool, Cyclophosphamide, administration & dosage, analogs & derivatives, Dactinomycin, administration & dosage, Epirubicin, administration & dosage, Etoposide, administration & dosage, Female, Humans, Idarubicin, administration & dosage, Ifosfamide, administration & dosage, Infant, Kaplan-Meiers Estimate, Male, Melphalan, administration & dosage, Sarcoma, drug therapy, mortality, Soft Tissue Neoplasms, drug therapy, mortality, Thiotepa, administration & dosage, Treatment Outcome, Vincristine, administration & dosage
Postens nummer:
Posten skapad:
2010-06-28 11:21

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