International journal of radiation oncology, biology, physics, 2011-06, Vol.80 (2), p.333-338
2011
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- Autor(en) / Beteiligte
- Titel
- Influence of Noncompliance With Radiation Therapy Protocol Guidelines and Operative Bed Recurrences for Children With Rhabdomyosarcoma and Microscopic Residual Disease: A Report From the Children's Oncology Group
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2011-06, Vol.80 (2), p.333-338
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2011
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- Purpose Postoperative radiation therapy (RT) is recommended for patients with rhabdomyosarcoma having microscopic disease. Sometimes RT dose/volume is reduced or omitted in an attempt to avoid late effects, particularly in young children. We reviewed operative bed recurrences to determine if noncompliance with RT protocol guidelines influenced local-regional control. Methods and Materials All operative bed recurrences among 695 Group II rhabdomyosarcoma patients in Intergroup Rhabdomyosarcoma Study Group (IRS) I through IV were reviewed for deviation from RT protocol. Major/minor dose deviation was defined as >10% or 6–10% of the prescribed dose (40–60 Gy), respectively. Major/minor volume deviation was defined as tumor excluded from the RT field or treatment volume not covered by the specified margin (preoperative tumor volume and 2- to 5-cm margin), respectively. No RT was a major deviation. Results Forty-six of 83 (55%) patients with operative bed recurrences did not receive the intended RT (39 major and 7 minor deviations). RT omission was the most frequent RT protocol deviation (19/46, 41%), followed by dose (17/46, 37%), volume (9/46, 20%), and dose and volume deviation (1/46, 2%). Only 7 operative bed recurrences occurred in IRS IV (5% local-regional failure) with only 3 RT protocol deviations. Sixty-three (76%) patients with recurrence died of disease despite retrieval therapy, including 13 of 19 nonirradiated children. Conclusion Over half of the operative bed recurrences were associated with noncompliance; omission of RT was the most common protocol deviation. Three fourths of children die when local-regional disease is not controlled, emphasizing the importance of RT in Group II rhabdomyosarcoma.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2010.01.058Titel-ID: cdi_osti_scitechconnect_21491770
- Format
- –
- Schlagworte
- Adolescent, Age Factors, AGE GROUPS, ANIMALS, Biological and medical sciences, Child, Child, Preschool, CHILDREN, Clinical Protocols, COMPLIANCE, Dermatology, DISEASES, Diseases of the osteoarticular system, DOSES, Group II, Guideline Adherence, Hematology, Oncology and Palliative Medicine, Humans, Infant, MAMMALS, MAN, Medical sciences, MEDICINE, Neoplasm Recurrence, Local - mortality, Neoplasm Recurrence, Local - radiotherapy, Neoplasm, Residual, NEOPLASMS, NUCLEAR MEDICINE, PRIMATES, Protocol compliance, RADIATION DOSES, Radiation therapy, RADIOLOGY, RADIOLOGY AND NUCLEAR MEDICINE, RADIOTHERAPY, Radiotherapy Dosage, RECOMMENDATIONS, Recurrence, Rhabdomyosarcoma, Rhabdomyosarcoma, Alveolar - mortality, Rhabdomyosarcoma, Alveolar - pathology, Rhabdomyosarcoma, Alveolar - radiotherapy, Rhabdomyosarcoma, Alveolar - surgery, Rhabdomyosarcoma, Embryonal - mortality, Rhabdomyosarcoma, Embryonal - pathology, Rhabdomyosarcoma, Embryonal - radiotherapy, Rhabdomyosarcoma, Embryonal - surgery, SARCOMAS, THERAPY, Tumor Burden, Tumors of striated muscle and skeleton, Tumors of the skin and soft tissue. Premalignant lesions, VERTEBRATES