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The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma
BACKGROUND: Magnetic resonance imaging (MRI) is the modality of choice for local staging and response evaluation of Ewing sarcoma (EwS). Aim of this study was to determine the relevance of tumor volume response (TVR) in relation to histological response (HisRes) and survival, in order to evaluate if...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434194/ https://www.ncbi.nlm.nih.gov/pubmed/30790456 http://dx.doi.org/10.1002/cam4.2002 |
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author | Haveman, Lianne M. Ranft, Andreas vd Berg, Henk Smets, Anne Kruseova, Jarmila Ladenstein, Ruth Brichard, Benedicte Paulussen, Michael Kuehne, Thomas Juergens, Heribert Klco‐Brosius, Stephanie Dirksen, Uta Merks, Johannes H.M. |
author_facet | Haveman, Lianne M. Ranft, Andreas vd Berg, Henk Smets, Anne Kruseova, Jarmila Ladenstein, Ruth Brichard, Benedicte Paulussen, Michael Kuehne, Thomas Juergens, Heribert Klco‐Brosius, Stephanie Dirksen, Uta Merks, Johannes H.M. |
author_sort | Haveman, Lianne M. |
collection | PubMed |
description | BACKGROUND: Magnetic resonance imaging (MRI) is the modality of choice for local staging and response evaluation of Ewing sarcoma (EwS). Aim of this study was to determine the relevance of tumor volume response (TVR) in relation to histological response (HisRes) and survival, in order to evaluate if early modification of chemotherapy might be indicated in patients with inadequate TVR. METHODS: Three dimensional (3D)‐tumor volume data at diagnosis, during early induction phase (1‐3 courses of chemotherapy; n = 195) and/or late induction phase (4‐6 courses; n = 175) from 241 localized patients were retrospectively analyzed. A distinction was made between adequate response (reduction ≥67%) and inadequate response (reduction <67% or progression). Correlations between TVR, HisRes, event free survival (EFS), and overall survival (OS) were analyzed using chi‐square tests, log‐rank tests, and the Cox‐regression model. RESULTS: Early adequate TVR, noted in 41% of patients, did not correlate with EFS (P = 0.92) or OS (P = 0.38). During late induction phase 62% of patients showed an adequate TVR. EFS for patients with late adequate TVR was better (78%) than for those with inadequate late TVR (61%) (P = 0.01); OS was 80% and 69% (P = 0.26), respectively. No correlation was found between TVR and HisRes. Multivariate analysis showed that poor HisRes, pelvic location and late inadequate TVR were associated with poor outcome. CONCLUSIONS: Early inadequate TVR does not predict adverse outcome; therefore, changing the treatment to second line chemotherapy is not indicated in case of inadequate early TVR. Late adequate TVR and good HisRes correlate with better EFS; patients with late inadequate TVR might benefit from augmented therapy. |
format | Online Article Text |
id | pubmed-6434194 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-64341942019-04-08 The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma Haveman, Lianne M. Ranft, Andreas vd Berg, Henk Smets, Anne Kruseova, Jarmila Ladenstein, Ruth Brichard, Benedicte Paulussen, Michael Kuehne, Thomas Juergens, Heribert Klco‐Brosius, Stephanie Dirksen, Uta Merks, Johannes H.M. Cancer Med Clinical Cancer Research BACKGROUND: Magnetic resonance imaging (MRI) is the modality of choice for local staging and response evaluation of Ewing sarcoma (EwS). Aim of this study was to determine the relevance of tumor volume response (TVR) in relation to histological response (HisRes) and survival, in order to evaluate if early modification of chemotherapy might be indicated in patients with inadequate TVR. METHODS: Three dimensional (3D)‐tumor volume data at diagnosis, during early induction phase (1‐3 courses of chemotherapy; n = 195) and/or late induction phase (4‐6 courses; n = 175) from 241 localized patients were retrospectively analyzed. A distinction was made between adequate response (reduction ≥67%) and inadequate response (reduction <67% or progression). Correlations between TVR, HisRes, event free survival (EFS), and overall survival (OS) were analyzed using chi‐square tests, log‐rank tests, and the Cox‐regression model. RESULTS: Early adequate TVR, noted in 41% of patients, did not correlate with EFS (P = 0.92) or OS (P = 0.38). During late induction phase 62% of patients showed an adequate TVR. EFS for patients with late adequate TVR was better (78%) than for those with inadequate late TVR (61%) (P = 0.01); OS was 80% and 69% (P = 0.26), respectively. No correlation was found between TVR and HisRes. Multivariate analysis showed that poor HisRes, pelvic location and late inadequate TVR were associated with poor outcome. CONCLUSIONS: Early inadequate TVR does not predict adverse outcome; therefore, changing the treatment to second line chemotherapy is not indicated in case of inadequate early TVR. Late adequate TVR and good HisRes correlate with better EFS; patients with late inadequate TVR might benefit from augmented therapy. John Wiley and Sons Inc. 2019-02-21 /pmc/articles/PMC6434194/ /pubmed/30790456 http://dx.doi.org/10.1002/cam4.2002 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Haveman, Lianne M. Ranft, Andreas vd Berg, Henk Smets, Anne Kruseova, Jarmila Ladenstein, Ruth Brichard, Benedicte Paulussen, Michael Kuehne, Thomas Juergens, Heribert Klco‐Brosius, Stephanie Dirksen, Uta Merks, Johannes H.M. The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title | The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title_full | The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title_fullStr | The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title_full_unstemmed | The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title_short | The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma |
title_sort | relation of radiological tumor volume response to histological response and outcome in patients with localized ewing sarcoma |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434194/ https://www.ncbi.nlm.nih.gov/pubmed/30790456 http://dx.doi.org/10.1002/cam4.2002 |
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