Original Research 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

被引：9

作者：

Groenendijk, Alissa ^{[1
]}

van Tinteren, Harm ^{[1
]}

Jiang, Yilin ^{[1
]}

de Krijger, Ronald R. ^{[1
,2
]}

Vujanic, Gordan M. ^{[3
]}

Godzinski, Jan ^{[4
,5
]}

Rube, Christian ^{[6
]}

Schenk, Jens-Peter ^{[7
]}

Morosi, Carlo ^{[8
]}

Pritchard-Jones, Kathy ^{[9
]}

Al-Saadi, Reem ^{[9
,10
]}

Vaidya, Sucheta J. ^{[11
]}

Verschuur, Arnauld C. ^{[12
]}

Ramirez-Villar, Gema L. ^{[13
]}

Graf, Norbert ^{[14
]}

de Camargo, Beatriz ^{[15
]}

Drost, Jarno ^{[1
,16
]}

Perotti, Daniela ^{[17
]}

Van den Heuvel-Eibrink, Marry M. ^{[1
]}

Brok, Jesper ^{[9
,18
]}

Spreafico, Filippo ^{[19
]}

Mavinkurve-Groothuis, Annelies M. C. ^{[1
]}

机构：

[1] Princess Maxima Ctr Pediat Oncol, Heidelberglaan 25, NL-3584 CS Utrecht, Netherlands

[2] Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands

[3] Sidra Med, Dept Pathol, Doha, Qatar

[4] Marciniak Hosp, Dept Pediat Surg, Wroclaw, Poland

[5] Med Univ Wroclaw, Dept Pediat Traumatol & Emergency Med, Wroclaw, Poland

[6] Saarland Univ, Med Ctr, Dept Radiat Oncol, Fac Med, Homburg, Germany

[7] Heidelberg Univ Hosp, Dept Diagnost & Intervent Radiol, Div Pediat Radiol, Heidelberg, Germany

[8] Fdn IRCCS Ist Nazl Tumori, Dept Radiol, Milan, Italy

[9] Univ Coll London Great Ormond St Inst Child Hlth, Dev Biol & Canc Res & Teaching Dept, London, England

[10] Great Ormond St Hosp Children NHS Fdn Trust, Dept Histopathol, London, England

[11] Royal Marsden Hosp, Children & Young Peoples Unit, Sutton, Surrey, England

[12] Hop Enfants La Timone, Dept Pediat Oncol, Marseille, France

[13] Hosp Univ Virgen del Rocio, Dept Pediat Oncol, Seville, Spain

[14] Saarland Univ, Med Ctr, Dept Pediat Oncol & Hematol, Fac Med, Homburg, Germany

[15] Inst Nacl Canc, Res Ctr, Pediat Hematol & Oncol Program, Rio De Janeiro, Brazil

[16] Oncode Inst, Utrecht, Netherlands

[17] Fdn IRCCS Ist Nazl Tumori, Dept Res, Mol Bases Genet Risk & Genet Testing Unit, Milan, Italy

[18] Rigshosp, Dept Pediat Oncol & Hematol, Copenhagen, Denmark

[19] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol & Hematol, Pediat Oncol Unit, Milan, Italy

来源：

EUROPEAN JOURNAL OF CANCER | 2022年 / 163卷

关键词：

Wilms tumour; Recurrence; SIOP protocol; Treatment outcome; DOXORUBICIN; SURVIVAL; CHILDREN; GAIN; 1Q;

D O I：

10.1016/j.ejca.2021.12.014

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Society of International Pediatric Oncology - 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 93-01 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]: 64.0-81.6%) and 79.3% (95% CI: 71.5-88.0%), 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: 0.228-1.638] [p-value = 0.327] and hazard ratio OS: 0.438 [95% CI: 0.126-1.700] [p-value = 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. (C) 2021 The Authors. Published by Elsevier Ltd.

引用

页码：88 / 97

页数：10

共 1 条

[1] Evaluation of boost irradiation in patients with intermediate-risk stage III Wilms tumour with positive lymph nodes only: Results from the SIOP-WT-2001 Registry
Davila Fajardo, Raquel
Oldenburger, Eva
Ruebe, Christian
Lopez-Yurda, Marta
Pritchard-Jones, Kathy
Bergeron, Christophe
Graf, Norbert
van Grotel, Martine
van Tinteren, Harm
Saunders, Daniel
van den Heuvel-Eibrink, Marry M.
Janssens, Geert O.
Oldenburger, Foppe
PEDIATRIC BLOOD & CANCER, 2018, 65 (08)

← 1 →