Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA.
Cancer Med. 2023 Jun;12(11):12777-12791. doi: 10.1002/cam4.5921. Epub 2023 Apr 20.
Racial and ethnic disparities have been demonstrated in pediatric and adult cancers. However, there is no consensus on whether such disparities exist in the presentation, treatment, and outcome of patients with rhabdomyosarcoma (RMS).
Patient information from the seven most recent RMS clinical trials was obtained from the Children's Oncology Group (COG). Chi-squared analyses were used to compare patient, tumor, and treatment characteristics across racial and ethnic groups. Pairwise analyses comparing Non-Hispanic Black (NHB) versus Non-Hispanic White (NHW) racial groups and Hispanic versus NHW ethnic groups were conducted for significant characteristics. Kaplan-Meier method and Wilcoxon signed-rank tests were performed to analyze outcomes.
In the overall cohort (n = 2157), patients' self-identified race/ethnicity was: 0.4% American Indian/Alaska Native, 2.6% Asian, 12.6% Hispanic, 0.2% Native American/other Pacific Islander, 12.8% NHB, 61.9% NHW, and 9.6% unknown. Six characteristics differed by race/ethnicity: age, histology, IRS group, invasiveness, metastatic disease, and FOXO1 fusion partner. Five were significant in pairwise comparisons: NHB patients were more likely to present at age ≥ 10 years and with invasive tumors than NHW patients; Hispanic patients were more likely to present with alveolar histology, metastatic disease, and IRS group IV disease than NHW patients. No differences were found in event free or overall survival of the entire cohort, in risk group-based subset analyses, or among patients with high-risk characteristics significant on pairwise analysis.
While NHB and Hispanic patients enrolled in COG trials presented with higher risk features than NHW patients, there were no outcome differences by racial or ethnic group.
儿科和成人癌症中已经存在种族和民族差异。然而，对于横纹肌肉瘤（RMS）患者的表现、治疗和结局是否存在这种差异，尚无共识。
从儿童肿瘤学组（COG）获得了最近的七项 RMS 临床试验的患者信息。使用卡方分析比较了不同种族和民族组的患者、肿瘤和治疗特征。对于有显著差异的特征，进行了非西班牙裔黑人（NHB）与非西班牙裔白人（NHW）种族组和西班牙裔与 NHW 族裔组的两两比较分析。采用 Kaplan-Meier 法和 Wilcoxon 符号秩检验分析结局。
在整个队列（n=2157）中，患者自我认定的种族/民族为：0.4%美洲印第安人/阿拉斯加原住民，2.6%亚洲人，12.6%西班牙裔，0.2%美洲原住民/其他太平洋岛民，12.8% NHB，61.9% NHW 和 9.6%未知。有 6 个特征因种族/民族而异：年龄、组织学、IRS 组、侵袭性、转移性疾病和 FOXO1 融合伙伴。在两两比较中有 5 个具有显著差异：NHB 患者比 NHW 患者更有可能在年龄≥10 岁和具有侵袭性肿瘤时就诊；西班牙裔患者比 NHW 患者更有可能出现肺泡组织学、转移性疾病和 IRS 组 IV 疾病。在整个队列的无事件生存和总生存、风险组亚组分析或在具有显著两两分析特征的高危患者中，均未发现差异。
虽然 COG 试验入组的 NHB 和西班牙裔患者具有比 NHW 患者更高的风险特征，但种族或民族群体之间的结局没有差异。
