Assessment of the Treatment Approach and Survival Outcomes in a Modern Cohort of Patients With Atypical Teratoid Rhabdoid Tumors Using the National Cancer Database

被引:51
作者
Fischer-Valuck, Benjamin W. [1 ]
Chen, Ishita [1 ]
Srivastava, Amar J. [1 ]
Floberg, John M. [1 ]
Rao, Yuan James [1 ]
King, Allison A. [2 ]
Shinohara, Eric T. [3 ]
Perkins, Stephanie M. [1 ]
机构
[1] Washington Univ, Sch Med, Dept Radiat Oncol, 4921 Parkview Pl,Lower Level, St Louis, MO 63110 USA
[2] Washington Univ, Sch Med, Dept Pediat Hematol & Oncol, St Louis, MO USA
[3] Vanderbilt Univ, Dept Radiat Oncol, 221 Kirkland Hall, Nashville, TN 37235 USA
关键词
atypical teratoid rhabdoid tumor (ATRT); National Cancer Database (NCDB); pediatric oncology; CENTRAL-NERVOUS-SYSTEM; TERATOID/RHABDOID TUMOR; RADIATION-THERAPY; RISK-FACTORS; CHILDREN; CHILDHOOD; AGE; MEDULLOBLASTOMA; RADIOTHERAPY; EXPERIENCE;
D O I
10.1002/cncr.30405
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Atypical teratoid rhabdoid tumors (ATRTs) are rare brain tumors that occur primarily in children under the age of 3 years. This report evaluates the treatment approach and survival outcomes in a large cohort of patients treated in the United States. METHODS: Using the National Cancer Database, the analysis included all ATRT patients aged 0 to 18 years who were diagnosed between 2004 and 2012 and had complete treatment data. RESULTS: Three hundred sixty-one ATRT patients were evaluated. The 5-year overall survival (OS) rate was 29.9%, and it was significantly lower for children who were less than 3 years old (5-year OS, 27.7%) versus those who were 3 years old or older (5-year OS, 37.5%; P<.001). The best outcome was seen for patients with localized disease who received trimodality therapy (surgery, chemotherapy, and radiation therapy [RT]) with a 5-year OS rate of 46.8%. The utilization of trimodality therapy significantly increased during the study period (27.7% in 2004-2008 vs 45.1% in 2009-2012; P<.01), largely because of the increased use of RT. In a multivariate analysis, treatment that did not utilize trimodality therapy was associated with significantly worse OS (hazard ratio, 2.52; 95% confidence interval (1.82-3.51). Children aged 0 to 2 years were significantly less likely to receive trimodality therapy because of decreased utilization of RT in this age group. CONCLUSIONS: The use of trimodality therapy significantly increased during the study period and was associated with improved outcomes. For patients with localized disease who received trimodality therapy, the OS rate at 5 years approached 50%. However, further research into the optimal management of children less than 3 years old is needed because of their significantly worse OS in comparison with older children. (C) 2016 American Cancer Society.
引用
收藏
页码:682 / 687
页数:6
相关论文
共 19 条
  • [1] Atypical teratoid/rhabdoid tumor of the central nervous system: A highly malignant tumor of infancy and childhood frequently mistaken for medulloblastoma - A pediatric oncology group study
    Burger, PC
    Yu, IT
    Tihan, T
    Friedman, HS
    Strother, DR
    Kepner, JL
    Duffner, PK
    Kun, LE
    Perlman, EJ
    [J]. AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1998, 22 (09) : 1083 - 1092
  • [2] Survival outcomes in atypical teratoid rhabdoid tumor for patients undergoing radiotherapy in a Surveillance, Epidemiology, and End Results analysis
    Buscariollo, Daniela L.
    Park, Henry S.
    Roberts, Kenneth B.
    Yu, James B.
    [J]. CANCER, 2012, 118 (17) : 4212 - 4219
  • [3] Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience)
    Chen, YW
    Wong, TT
    Ho, DMT
    Huang, PI
    Chang, KP
    Shiau, CY
    Yen, SH
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2006, 64 (04): : 1038 - 1043
  • [4] Intensive Multimodality Treatment for Children With Newly Diagnosed CNS Atypical Teratoid Rhabdoid Tumor
    Chi, Susan N.
    Zimmerman, Mary Ann
    Yao, Xiaopan
    Cohen, Kenneth J.
    Burger, Peter
    Biegel, Jaclyn A.
    Rorke-Adams, Lucy B.
    Fisher, Michael J.
    Janss, Anna
    Mazewski, Claire
    Goldman, Stewart
    Manley, Peter E.
    Bowers, Daniel C.
    Bendel, Anne
    Rubin, Joshua
    Turner, Christopher D.
    Marcus, Karen J.
    Goumnerova, Liliana
    Ullrich, Nicole J.
    Kieran, Mark W.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (03) : 385 - 389
  • [5] INVESTIGATING VERBAL AND VISUAL AUDITORY LEARNING AFTER CONFORMAL RADIATION THERAPY FOR CHILDHOOD EPENDYMOMA
    Di Pinto, Marcos
    Conklin, Heather M.
    Li, Chenghong
    Xiong, Xaoping
    Merchant, Thomas E.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2010, 77 (04): : 1002 - 1008
  • [6] Central nervous system atypical teratoid/rhabdoid tumor: Results of therapy in children enrolled in a registry
    Hilden, JM
    Meerbaum, S
    Burger, P
    Finlay, J
    Janss, A
    Scheithauer, BW
    Walter, AW
    Rorke, LB
    Biegel, JA
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (14) : 2877 - 2884
  • [7] Atypical teratoid/rhabdoid tumor of the central nervous system: a comparative study with primitive neuroectodermal tumor/medulloblastoma
    Ho, DMT
    Hsu, CY
    Wong, TT
    Ting, LT
    Chiang, H
    [J]. ACTA NEUROPATHOLOGICA, 2000, 99 (05) : 482 - 488
  • [8] Central nervous system atypical teratoid rhabdoid tumours: The Canadian Paediatric Brain Tumour Consortium experience
    Lafay-Cousin, L.
    Hawkins, C.
    Carret, A. S.
    Johnston, D.
    Zelcer, S.
    Wilson, B.
    Jabado, N.
    Scheinemann, K.
    Eisenstat, D.
    Fryer, C.
    Fleming, A.
    Mpofu, C.
    Larouche, V.
    Strother, D.
    Bouffet, E.
    Huang, A.
    [J]. EUROPEAN JOURNAL OF CANCER, 2012, 48 (03) : 353 - 359
  • [9] Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study
    Merchant, Thomas E.
    Li, Chenghong
    Xiong, Xiaoping
    Kun, Larry E.
    Boop, Frederic A.
    Sanford, Robert A.
    [J]. LANCET ONCOLOGY, 2009, 10 (03) : 258 - 266
  • [10] Long-Term Cognitive Sequelae After Pediatric Brain Tumor Related to Medical Risk Factors, Age, and Sex
    Olsson, Ingrid Tonning
    Perrin, Sean
    Lundgren, Johan
    Hjorth, Lars
    Johanson, Aid
    [J]. PEDIATRIC NEUROLOGY, 2014, 51 (04) : 515 - 521