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Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study.
Pediatr Blood Cancer. 2005 Oct 15; 45(5):676-82.PB

Abstract

PURPOSE

To analyze patterns of treatment failure in infants with primitive neuroectodermal tumors (PNETs) who were treated primarily with chemotherapy in a large multi-institutional study.

MATERIALS AND METHODS

Sixty-five prospectively staged patients with PNET confirmed by central pathology review, who were 18 months or younger were treated on Children's Cancer Group Study 921 (CCG-921) primarily with chemotherapy. Forty-six patients had posterior fossa (PF) primary tumors and 19 patients had supratentorial (ST) primaries. Patterns of sites of initial treatment failure were analyzed and compared to failure patterns of 180 older children who had PF-PNETs, and 44 older children with ST-PNETs who were treated on the same protocol.

RESULTS

The entire cohort of younger patients fared much worse than those older than 18 months. Cumulative 5-year relapse incidence (+/-SE) for younger patients with PF-PNETs was 64.5 +/- 8.9% for patients without metastases (M0) compared to 71.4 +/- 13.4% for patients with metastases (M+). The cumulative 5-year relapse incidences for younger patients with ST-PNETs were 64.3 +/- 13.7% for M0 patients compared to 100 +/- 33.3% for M+ patients. Relapses in these patients occurred within 2 years. The overall treatment failure rate was significantly higher for younger compared to older patients with PF-PNET and ST-PNET. There was no statistically significant difference in relapse patterns between patients with PF primary tumors and ST primaries when stratified by stage. There was no statistically significant difference in relapse patterns between M0 and M+ patients. All patients had a high risk of recurrence at primary tumor site. Younger patients who had PF primary tumors without metastasis at presentation were significantly more likely to relapse in PF than older patients. Younger patients were at significant risk of relapse in the spine, but none had it as the sole site of first relapse.

CONCLUSIONS

Despite aggressive chemotherapy, younger children with PNETs have high rates of treatment failure and fare worse than high-risk, older patients with PF-PNETs, indicating the need to maximize local, regional, and systemic therapies.

Authors+Show Affiliations

Department of Human Oncology, School of Medicine, University of Wisconsin, Madison, WI 53792, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16007595

Citation

Hong, Theodore S., et al. "Patterns of Treatment Failure in Infants With Primitive Neuroectodermal Tumors Who Were Treated On CCG-921: a Phase III Combined Modality Study." Pediatric Blood & Cancer, vol. 45, no. 5, 2005, pp. 676-82.
Hong TS, Mehta MP, Boyett JM, et al. Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study. Pediatr Blood Cancer. 2005;45(5):676-82.
Hong, T. S., Mehta, M. P., Boyett, J. M., Donahue, B., Rorke, L. B., & Zeltzer, P. M. (2005). Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study. Pediatric Blood & Cancer, 45(5), 676-82.
Hong TS, et al. Patterns of Treatment Failure in Infants With Primitive Neuroectodermal Tumors Who Were Treated On CCG-921: a Phase III Combined Modality Study. Pediatr Blood Cancer. 2005 Oct 15;45(5):676-82. PubMed PMID: 16007595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-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 - Zeltzer,Paul M, PY - 2005/7/12/pubmed PY - 2005/11/9/medline PY - 2005/7/12/entrez SP - 676 EP - 82 JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 45 IS - 5 N2 - PURPOSE: To analyze patterns of treatment failure in infants with primitive neuroectodermal tumors (PNETs) who were treated primarily with chemotherapy in a large multi-institutional study. MATERIALS AND METHODS: Sixty-five prospectively staged patients with PNET confirmed by central pathology review, who were 18 months or younger were treated on Children's Cancer Group Study 921 (CCG-921) primarily with chemotherapy. Forty-six patients had posterior fossa (PF) primary tumors and 19 patients had supratentorial (ST) primaries. Patterns of sites of initial treatment failure were analyzed and compared to failure patterns of 180 older children who had PF-PNETs, and 44 older children with ST-PNETs who were treated on the same protocol. RESULTS: The entire cohort of younger patients fared much worse than those older than 18 months. Cumulative 5-year relapse incidence (+/-SE) for younger patients with PF-PNETs was 64.5 +/- 8.9% for patients without metastases (M0) compared to 71.4 +/- 13.4% for patients with metastases (M+). The cumulative 5-year relapse incidences for younger patients with ST-PNETs were 64.3 +/- 13.7% for M0 patients compared to 100 +/- 33.3% for M+ patients. Relapses in these patients occurred within 2 years. The overall treatment failure rate was significantly higher for younger compared to older patients with PF-PNET and ST-PNET. There was no statistically significant difference in relapse patterns between patients with PF primary tumors and ST primaries when stratified by stage. There was no statistically significant difference in relapse patterns between M0 and M+ patients. All patients had a high risk of recurrence at primary tumor site. Younger patients who had PF primary tumors without metastasis at presentation were significantly more likely to relapse in PF than older patients. Younger patients were at significant risk of relapse in the spine, but none had it as the sole site of first relapse. CONCLUSIONS: Despite aggressive chemotherapy, younger children with PNETs have high rates of treatment failure and fare worse than high-risk, older patients with PF-PNETs, indicating the need to maximize local, regional, and systemic therapies. SN - 1545-5009 UR - https://www.unboundmedicine.com/medline/citation/16007595/Patterns_of_treatment_failure_in_infants_with_primitive_neuroectodermal_tumors_who_were_treated_on_CCG_921:_a_phase_III_combined_modality_study_ L2 - https://doi.org/10.1002/pbc.20184 DB - PRIME DP - Unbound Medicine ER -