Division of Pediatrics, The Children's Cancer Hospital, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Pediatr Blood Cancer. 2010 Oct;55(4):612-6. doi: 10.1002/pbc.22520.
To assess local control, event-free survival (EFS), and overall survival (OS) rates in 71 patients with localized, completely resected (Group I) alveolar rhabdomyosarcoma (ALV RMS) and their relation to radiation therapy (RT) on IRSG Protocols III and IV, 1984-1997.
Chart review and standard statistical procedures. PATIENTS AND TUMORS: Patients were 1-18 years at diagnosis (median, 6 years). Primary tumor sites were extremity/trunk (N = 54), head/neck (N = 9), genitourinary tract (N = 7), and perineum (N = 1). Thirty patients received VA +/- C with RT; 41 received VA +/- C alone. RT was assigned, not randomized.
Fifty-four patients had Stage 1 (favorable site, any size) or Stage 2 (unfavorable site, < or = 5 cm) tumors. Eight-year EFS was 90%, with 100% local control for 17 patients given RT. Eight-year EFS was 88%, with 92% local control for 37 patients without RT; P = 0.52 for EFS comparisons, 0.3 for local control comparisons. In 17 Stage 3 patients (unfavorable site, tumors >5 cm, N0), 8-year EFS was 84% with 100% local control in 13 patients given RT; 8-year EFS was only 25% and local control 50% in 4 patients without RT. Local recurrence was the most common site of first failure in non-irradiated patients.
Patients with Stage 1-2 ALV RMS had slightly but statistically insignificantly improved local control, EFS, and OS rates when local RT was given. The need for local RT in Stage 1-2 patients deserves evaluation in a randomized study. Local control, EFS, and OS rates were significantly improved in Stage 3 patients receiving local RT.
评估 IRSG 协议 III 和 IV（1984-1997 年）中 71 例局部完全切除（I 组）肺泡横纹肌肉瘤（ALV RMS）患者的局部控制率、无事件生存率（EFS）和总生存率（OS），并分析其与放疗（RT）的关系。
病历回顾和标准统计程序。
诊断时患者年龄为 1-18 岁（中位数为 6 岁）。原发肿瘤部位为四肢/躯干（N=54）、头颈部（N=9）、泌尿生殖系统（N=7）和会阴（N=1）。30 例患者接受 VA +/- C 联合 RT；41 例患者仅接受 VA +/- C。RT 是根据情况而非随机分配的。
54 例患者为 I 期（好发部位，任何大小）或 II 期（非好发部位，<或=5cm）肿瘤。17 例接受 RT 的患者 8 年 EFS 为 90%，局部控制率为 100%。37 例未接受 RT 的患者 8 年 EFS 为 88%，局部控制率为 92%；EFS 比较 P=0.52，局部控制比较 P=0.3。17 例 III 期（非好发部位，肿瘤>5cm，N0）患者中，13 例接受 RT 的患者 8 年 EFS 为 84%，局部控制率为 100%；4 例未接受 RT 的患者 8 年 EFS 仅为 25%，局部控制率为 50%。非放疗患者中，局部复发是首次失败的最常见部位。
I 期-2 期 ALV RMS 患者局部接受 RT 后，局部控制率、EFS 和 OS 率略有但无统计学意义的提高。在随机研究中，需要评估 I 期-2 期患者局部 RT 的必要性。接受局部 RT 的 III 期患者局部控制率、EFS 和 OS 率显著提高。
