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Patterns of failure in supratentorial primitive neuroectodermal tumors treated in Children's Cancer Group Study 921, a phase III combined modality study.
Int J Radiat Oncol Biol Phys. 2004 Sep 01; 60(1):204-13.IJ

Abstract

PURPOSE

To analyze the patterns of failure in patients with supratentorial primitive neuroectodermal tumors (ST-PNETs) treated with combined modality therapy in a large, randomized, multi-institutional study.

METHODS AND MATERIALS

A total of 44 prospectively staged patients with ST-PNET confirmed by central pathology review were treated in the Children's Cancer Group Study 921, which compared two chemoradiotherapy regimens. The patterns of initial sites of failure were analyzed. These were compared with the failure patterns of 188 children with posterior fossa (PF) PNETs treated in the same protocol.

RESULTS

The major determinant for progression-free survival was the initial metastatic stage. The 3-year progression-free survival for M0 patients was 53% +/- 8.5% compared with 14% +/- 9.4% for M+ patients. The cumulative 5-year relapse incidence was 71.4% +/- 21% for M+ patients compared with 47.5% +/- 8.6% for M0 patients. The overall failure rate for both M0 and M+ ST-PNETs was greater than that for PF-PNETs (47.5% +/- 8.6% vs. 29.3% +/- 4.7% for M0 and 71.4% +/- 21% vs. 48.4% +/- 5.5% for M+). Failure at the primary site, either as the sole site or as a component of initial failure, was also seen more frequently in ST-PNETs than in PF-PNETs. For M0 patients, the 5-year local failure rate as a component of initial failure was 42.0% +/- 8.5% for ST-PNETs compared with 17.7% +/- 3.9% for PF-PNETs. For patients with primary tumors either in the ST or PF, the 5-year spinal axis failure rate as a component of initial failure was not significantly different statistically when compared by M stage. For M+ patients, the 5-year spinal axis failure rate as a component of initial failure was 42.9% +/- 22.8% for ST-PNETs and 34.6% +/- 5.2% for PF-PNETs.

CONCLUSION

Despite aggressive combined modality therapy, ST-PNETs had high rates of failure, with M+ patients faring especially poorly. Both local and spinal failure rates remained high, indicating the need to maximize both local and regional/systemic therapies. Overall, these patients fared worse than those with high-risk PF-PNETs in terms of progression-free survival and failure rates.

Authors+Show Affiliations

Department of Human Oncology, University of Wisconsin School of Medicine, Madison, WI, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15337557

Citation

Hong, Theodore S., et al. "Patterns of Failure in Supratentorial Primitive Neuroectodermal Tumors Treated in Children's Cancer Group Study 921, a Phase III Combined Modality Study." International Journal of Radiation Oncology, Biology, Physics, vol. 60, no. 1, 2004, pp. 204-13.
Hong TS, Mehta MP, Boyett JM, et al. Patterns of failure in supratentorial primitive neuroectodermal tumors treated in Children's Cancer Group Study 921, a phase III combined modality study. Int J Radiat Oncol Biol Phys. 2004;60(1):204-13.
Hong, T. S., Mehta, M. P., Boyett, J. M., Donahue, B., Rorke, L. B., Yao, M. S., & Zeltzer, P. M. (2004). Patterns of failure in supratentorial primitive neuroectodermal tumors treated in Children's Cancer Group Study 921, a phase III combined modality study. International Journal of Radiation Oncology, Biology, Physics, 60(1), 204-13.
Hong TS, et al. Patterns of Failure in Supratentorial Primitive Neuroectodermal Tumors Treated in Children's Cancer Group Study 921, a Phase III Combined Modality Study. Int J Radiat Oncol Biol Phys. 2004 Sep 1;60(1):204-13. PubMed PMID: 15337557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of failure in supratentorial primitive neuroectodermal tumors treated in Children's Cancer Group Study 921, a phase III combined modality study. AU - Hong,Theodore S, AU - Mehta,Minesh P, AU - Boyett,James M, AU - Donahue,Bernadine, AU - Rorke,Lucy B, AU - Yao,Michelle S, AU - Zeltzer,Paul M, PY - 2003/09/16/received PY - 2004/02/02/revised PY - 2004/02/09/accepted PY - 2004/9/1/pubmed PY - 2004/10/8/medline PY - 2004/9/1/entrez SP - 204 EP - 13 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 60 IS - 1 N2 - PURPOSE: To analyze the patterns of failure in patients with supratentorial primitive neuroectodermal tumors (ST-PNETs) treated with combined modality therapy in a large, randomized, multi-institutional study. METHODS AND MATERIALS: A total of 44 prospectively staged patients with ST-PNET confirmed by central pathology review were treated in the Children's Cancer Group Study 921, which compared two chemoradiotherapy regimens. The patterns of initial sites of failure were analyzed. These were compared with the failure patterns of 188 children with posterior fossa (PF) PNETs treated in the same protocol. RESULTS: The major determinant for progression-free survival was the initial metastatic stage. The 3-year progression-free survival for M0 patients was 53% +/- 8.5% compared with 14% +/- 9.4% for M+ patients. The cumulative 5-year relapse incidence was 71.4% +/- 21% for M+ patients compared with 47.5% +/- 8.6% for M0 patients. The overall failure rate for both M0 and M+ ST-PNETs was greater than that for PF-PNETs (47.5% +/- 8.6% vs. 29.3% +/- 4.7% for M0 and 71.4% +/- 21% vs. 48.4% +/- 5.5% for M+). Failure at the primary site, either as the sole site or as a component of initial failure, was also seen more frequently in ST-PNETs than in PF-PNETs. For M0 patients, the 5-year local failure rate as a component of initial failure was 42.0% +/- 8.5% for ST-PNETs compared with 17.7% +/- 3.9% for PF-PNETs. For patients with primary tumors either in the ST or PF, the 5-year spinal axis failure rate as a component of initial failure was not significantly different statistically when compared by M stage. For M+ patients, the 5-year spinal axis failure rate as a component of initial failure was 42.9% +/- 22.8% for ST-PNETs and 34.6% +/- 5.2% for PF-PNETs. CONCLUSION: Despite aggressive combined modality therapy, ST-PNETs had high rates of failure, with M+ patients faring especially poorly. Both local and spinal failure rates remained high, indicating the need to maximize both local and regional/systemic therapies. Overall, these patients fared worse than those with high-risk PF-PNETs in terms of progression-free survival and failure rates. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/15337557/Patterns_of_failure_in_supratentorial_primitive_neuroectodermal_tumors_treated_in_Children's_Cancer_Group_Study_921_a_phase_III_combined_modality_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360301604002500 DB - PRIME DP - Unbound Medicine ER -