Results From the IRS IV Randomized Trial of Hyperfractionated Radiation in Children with Rhabdomyosarcoma

Joel W. Goldwein, MD
OncoLink co-Editor-In-Chief
Ultima Vez Modificado: 24 de octubre del 2000

Share article


English

Presenter: S. S. Donaldson, MD
Affiliation: The Intergroup Rhabdomyosarcoma Study


Background:

  • Hyperfractionated radiation therapy (HFRT) has the theoretical potential for improving efficacy without producing more late effects of children with rhabdomyosarcoma (RMS).

  • This analysis of the IRS experience in treating rhabdomyosarcomas with HFRT is the first phase III randomized trial of this therapy reported for children


Materials and Methods:

  • Children with Group III (gross residual tumor) rhabdomyosarcoma were randomized to receive either 50.4 Gy standard RT or 59.4 Gy in 1.1 Gy BID fractions HFRT, both beginning about week 9 post-resection and after initial chemotherapy

  • The dose of HFRT was predicted (based on alpha/beta model) to increase effective tumor dose by 10% without increasing the late toxicity


Results:

  • 450 children were analyzed, 251 of whom received HFRT and 239 of whom received conventional RT

  • Compliance to radiation protocol was only 57% for patients <= 5 years of age, and 88% for older patients

  • Five year actuarial survival was 75%, and relapse-free survival was 70%

  • There was no significant difference in survival for the 2 groups

  • When analyzed by intent to treat, there was no significant difference on freedom-from-relapse for the 2 groups

  • Local failure rate was 12% for the conventional RT patients and 15% for the HFRT patients; this was not significantly different

  • Grade III and IV toxicity was 86% in the conventional RT group and 89% in the HFRT group; also not significantly different


Authors' Conclusions

  • HFRT as described above does not improve tumor control in these patients


Clinical/Scientific Implications:

  • Conventional RT remains the standard of care for children with Group III rhabdomyosarcoma

English
News
Trial results show longer progression-free survival with sunitinib and everolimus

Feb 10, 2011 - The results of two phase 3, randomized controlled trials suggest that two therapies, sunitinib and everolimus, hold promise in the treatment of patients with advanced pancreatic neuroendocrine tumors; the findings of these trials have been published in the Feb. 10 issue of the New England Journal of Medicine.



I Wish You Knew

How cancer patients have changed my life

View More



Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.




OncoLink OncoPilot

Frente a un nuevo diagnóstico de cáncer o de cambiar el curso de su tratamiento actual? Deje que nuestro personal de enfermería cáncer que ayudan a pasar!

Más información