Debs Patrick, Bhatia Rohini, Kruglyakova Jacqueline, Ke Suqi, Hu Chen, Ladra Matthew, Pratilas Christine A, Ahlawat Shivani, Fayad Laura M, Acharya Sahaja
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Adv Radiat Oncol. 2024 Jun 29;9(8):101561. doi: 10.1016/j.adro.2024.101561. eCollection 2024 Aug.
To describe early tumor volume change in patients with rhabdomyosarcoma (RMS) and investigate its association with overall survival (OS) and local failure.
This retrospective study included patients who received diagnoses of group III/IV RMS with available computed tomography and/or magnetic resonance imaging scans at 2 time points: (1) pretherapy and (2) early therapy (acquired during weeks 8-12 of chemotherapy). Relative volumetric change (RVC) was calculated as the percentage of (early therapy - pretherapy volume) / (pretherapy volume). Cox regression was used to identify variables associated with OS. The Fine-Gray model was used to estimate local failure.
Eligible patients (n = 55) had the following characteristics: median age at diagnosis, 9.6 years and median follow-up, 30.4 months. Most tumors were alveolar (61.8%), followed by embryonal (34.6%) and spindle cell/sclerosing (4%). The median RVC was -86.4% with larger decreases observed in alveolar versus nonalveolar RMS (-89.4% vs -69.8%, = .043). For embryonal and spindle cell/sclerosing RMS, all of which were FOXO1 fusion negative, RVC was independently associated with OS (hazard ratio for every 50% reduction in RVC [HR], 0.5; 95% CI, 0.26-0.96; = .037) and local failure (HR, 0.57; 95% CI, 0.33-0.99; = .049). The predominant pattern of failure in embryonal and spindle cell/sclerosing RMS was local, and most were group III.
There was a greater reduction in tumor volume in alveolar versus nonalveolar RMS. Early tumor volume reduction was associated with OS and local failure in embryonal or spindle cell/sclerosing RMS, all of which were confirmed FOXO1 fusion negative and had higher incidence of local compared with distant failures.
描述横纹肌肉瘤（RMS）患者早期肿瘤体积变化，并研究其与总生存期（OS）和局部复发的相关性。
这项回顾性研究纳入了诊断为III/IV期RMS且在两个时间点有可用计算机断层扫描和/或磁共振成像扫描的患者：（1）治疗前；（2）早期治疗（在化疗第8 - 12周期间获得）。相对体积变化（RVC）计算为（早期治疗体积 - 治疗前体积）/（治疗前体积）的百分比。使用Cox回归确定与OS相关的变量。使用Fine - Gray模型估计局部复发。
符合条件的患者（n = 55）具有以下特征：诊断时的中位年龄为9.6岁，中位随访时间为30.4个月。大多数肿瘤为肺泡型（61.8%），其次是胚胎型（34.6%）和梭形细胞/硬化型（4%）。中位RVC为 - 86.4%，肺泡型RMS比非肺泡型RMS体积减少更大（-89.4%对 - 69.8%，P = 0.043）。对于胚胎型和梭形细胞/硬化型RMS，所有这些均为FOXO1融合阴性，RVC与OS（RVC每降低50%的风险比[HR]，0.5；95%置信区间，0.26 - 0.96；P = 0.037）和局部复发（HR，0.57；95%置信区间，0.33 - 0.99；P = 0.049）独立相关。胚胎型和梭形细胞/硬化型RMS的主要复发模式是局部复发，且大多数为III期。
肺泡型RMS比非肺泡型RMS的肿瘤体积减少更大。胚胎型或梭形细胞/硬化型RMS（均为FOXO1融合阴性且局部复发发生率高于远处复发）的早期肿瘤体积缩小与OS和局部复发相关。
