Randomized study of intensive MOPP-ABVD with or without low-dose total-nodal radiation therapy in the treatment of stages IIB, IIIA2, IIIB and IV Hodgkin's disease in pediatric patients: a pediatric oncology group study

Weiner, MA; Leventhalt, B; Ml, Brecher; Marcus, R.E.; Cantor, Alan; Gieser, PW; Jl, Ternberg; Behm, FG; Wharam,; Chauvenet, A

doi:10.1016/s1278-3218(98)89073-2

Cited by 34 publications

(44 citation statements)

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“…[1][2][3][4][5][6] European rhabdomyosarcoma (RMS) clinical trials use radiographic response to initial therapy to tailor subsequent therapy in an attempt to minimize toxicity yet maximize survival. 7,8 This treatment philosophy assumes that initial response to therapy is associated with ultimate outcome and can identify chemotherapy-sensitive tumors more likely to be cured with systemic therapy.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Tumor Response at the End of Therapy in Group III Rhabdomyosarcoma: A Report From the Children's Oncology Group

Rodeberg

Stoner

Hayes‐Jordan

et al. 2009

JCO

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A B S T R A C T PurposeSome patients with rhabdomyosarcoma (RMS) achieve less than a complete response (CR) despite receiving all planned therapy. We assessed the impact of best response at the completion of all therapy on patient outcome. Patients and MethodsWe studied 419 clinical group III participants who completed all protocol therapy without developing progressive disease for Intergroup Rhabdomyosarcoma Study (IRS) IV. Response (complete resolution [CR], partial response [PR; Ն 50% decrease], or no response [NR; Ͻ 50% decrease and Ͻ 25% increase]) was determined by radiographic measurement and categorized by the best response. ResultsAt the end of therapy, 341 participants (81%) achieved a best response of CR and 78 (19%) had a best response of PR/NR. Five-year failure-free survival was similar for participants achieving CR (80%) and PR/NR (78%). After adjustment for age, nodal status, primary site, and histology, there was no significant indication of lower risk of failure (hazard ratio [HR], 0.77; 95% CI, 0.46 to 1.27; P ϭ .3) nor death (HR, 0.63; 95% CI, 0.36 to 1.09; P ϭ .1) for CR versus PR/NR participants. Seventeen participants with a best response of PR/NR had surgical procedures; eight (50%) of 16 with available pathology reports had residual viable tumor and only three achieved a complete resection. Resection of residual masses was not associated with improved outcome. ConclusionCR status at the end of protocol therapy in clinical group III participants was not associated with a reduction of disease recurrence and death. Aggressive alternative therapy may not be warranted for RMS patients with a residual mass at the end of planned therapy.

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Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Tumor Response at the End of Therapy in Group III Rhabdomyosarcoma: A Report From the Children's Oncology Group

Rodeberg

Stoner

Hayes‐Jordan

et al. 2009

JCO

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“…While chemotherapy has replaced total nodal irradiation (TNI) as the standard of therapy for Hodgkin's disease, 6,7 the initial success of TNI in treating Hodgkin's disease was impetus for similar trials in autoimmune disorders, the results of which were, unfortunately, discouraging. These experiences tell us that success from using radiation in malignancies does not translate into similar successful outcomes for autoimmune diseases.…”

Section: Treatment Of Autoimmune Diseases With Radiationmentioning

confidence: 99%

The rationale behind autologous autoimmune hematopoietic stem cell transplant conditioning regimens: concerns over the use of total-body irradiation in systemic sclerosis

Burt

Kallunian

Patel

et al. 2004

Bone Marrow Transplant

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Summary:Hematopoietic stem cell transplantation (HSCT) is becoming an increasingly recognized indication for treatment of autoimmune diseases and severe immunemediated disorders. However, multicenter registry data have demonstrated higher than anticipated early toxicity, approximately 10% for autoimmune diseases in general, and 20-27% for diffuse systemic sclerosis (scleroderma). If uncorrected, this high treatment-related mortality will hinder development of stem cell therapy for immunemediated diseases. In order to develop safer regimens, we address some pitfalls and concepts involved in design and selection of conditioning regimens for autoimmune diseases in general, and because it is associated with the highest regimen-related toxicity, scleroderma in specific.

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“…Imaging of original disease and of response were collected by QARC. The published study (4) demonstrated no benefit to the addition of radiation therapy. A retrospective subset analysis found a statistically significant benefit in relapse free survival to those patients treated in a study compliant fashion (Table 1).…”

Section: Images Become a Point Of Validationmentioning

confidence: 95%

Processes for Quality Improvements in Radiation Oncology Clinical Trials

Fitzgerald¹,

Urie²,

Ulin³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Quality assurance in radiation therapy has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials data acquisition was non-uniform and inconsistent; computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of radiation therapy, evaluation processes for target definition, radiation therapy treatment planning and therapy execution undergo constant review. As we move to multi-modality image-based definitions of target volumes for protocols, future clinical trials will require near-real time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving and quantitative review of volumetric radiation therapy plans will be the primary challenge for future successful clinical trials.

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Randomized study of intensive MOPP-ABVD with or without low-dose total-nodal radiation therapy in the treatment of stages IIB, IIIA2, IIIB and IV Hodgkin's disease in pediatric patients: a pediatric oncology group study

Cited by 34 publications

References 0 publications

Prognostic Significance of Tumor Response at the End of Therapy in Group III Rhabdomyosarcoma: A Report From the Children's Oncology Group

Prognostic Significance of Tumor Response at the End of Therapy in Group III Rhabdomyosarcoma: A Report From the Children's Oncology Group

The rationale behind autologous autoimmune hematopoietic stem cell transplant conditioning regimens: concerns over the use of total-body irradiation in systemic sclerosis

Processes for Quality Improvements in Radiation Oncology Clinical Trials

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