In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 24, No. 18_suppl ( 2006-06-20), p. 9000-9000
Abstract:
9000 Background: CCSK was initially described by its bone metastasizing tendencies and propensity for late recurrences. Outcome for patients with CCSK has improved from NWTS 1–4. On NWTS 4 patients were randomized to treatment for 15 months vs 6 months. Their overall 8 year relapse free survival was 88% vs 61%, respectively. NWTS-5 was designed to improve the event free survival (EFS) and overall survival (S) for patients with CCSK by incorporating cyclophosphamide and etoposide. Methods: Prospective single-arm study conducted between August, 1995 and June, 2002. Patients less than 16 years of age with a centrally confirmed pathological diagnosis of CCSK were eligible. Staging consisted of CT scans of chest, abdomen, pelvis, bone scan, skeletal survey, and CT or MRI of head. Patients were treated with vincristine/doxorubicin/cyclophosphamide alternating with cyclophosphamide/etoposide for 24 weeks and XRT (10.8 cGy). Results: 110 eligible patients were enrolled on study. Median age was 22 months, 69% were males, and 63% white. Stage distribution was: stage I, 14; II, 41; III, 46; IV, 9 [metastatic sites: lung (3), bone (1), brain (1), liver (1), bone and bilateral lung (1) and other (2)] Median follow-up is 4.6 years. 5-year EFS and S were 79% (95% CI, 69% to 86%) and 89% (95% CI, 80% to 94%). All but one of 21 recurrences occurred within 3 years of initial treatment. The most common site of recurrence was brain (11/21). 5-year EFS for Stage I-IV was 100%, 87%, 74% and 36% respectively. Adverse prognostic factors for patients with Stage II/III disease were white race, and lymph node involvement. Conclusions: Outcome for patients with CCSK treated on NWTS-5 is similar to that seen on NWTS-4 and recent SIOP and UKCCSG trials. Stage is highly predictive of outcome. Brain recurrence was higher than that seen on NWTS-4; lung recurrences were lower. The next Childrens Oncology Group (COG) protocol will use the same treatment for patients with Stages I-III; therapy for patients with Stage IV disease will incorporate carboplatin. The role of XRT in CCSK needs to be evaluated. No significant financial relationships to disclose.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2006.24.18_suppl.9000
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2006
detail.hit.zdb_id:
2005181-5
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