title: Adherence to Treatment, Response and Patterns of Failure in Pediatric Parameningeal Rhabdomyosarcoma: Experience From a Tertiary Cancer Care Center From India.
abstract: The study was aimed at evaluating adherence to treatment protocol and outcome in pediatric parameningeal rhabdomyosarcoma (PM-RMS). We analyzed the characteristics, treatment administered, outcomes and patterns of failure of pediatric PM-RMS, who were treated with multimodality therapy between January 2005 and December 2013.Univariate and multivariate analysis (MVA) was completed to evaluate the impact of various prognostic factors. Thirty-seven patients were treated at our institution. Majority of them had the primary disease in paranasal sinuses (n=13). Majority of the patients belonged to group III (n=30) and stage III (n=24). The overall response rate to treatment was 52.5% (n=21). At a mean follow-up of 19.1 months, 23 patients developed disease progression. The actuarial rates of failure-free survival and overall survival (OS) at 2 years were 40% and 67.5%, respectively. Patients who received >20 weeks of intended chemotherapy schedule (P=0.02) and had complete response to first-line treatment (P=0.0004) were found to have superior failure-free survival on MVA. Complete response was the lone determinant of superior OS on MVA (P=0.006). Majority of patients with PM-RMS present with advanced stage disease. Response to first-line treatment is a significant predictor of superior progression-free survival and OS in these patients.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Soumyajit
authors.initials: S
authors.lastname: Roy
authors.forename: Sushmita
authors.initials: S
authors.lastname: Pathy
authors.forename: Bidhu K
authors.initials: BK
authors.lastname: Mohanti
authors.forename: Subhash
authors.initials: S
authors.lastname: Chander
authors.forename: Ahitagni
authors.initials: A
authors.lastname: Biswas
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D059248:Chemoradiotherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D010166:Palliative Care; D010255:Paranasal Sinus Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy; D010349:Patient Compliance; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D016879:Salvage Therapy; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D003520:Cyclophosphamide