Treatment of children with relapsed soft tissue sarcoma: Report of the German CESS/CWS REZ 91 Trial

Klingebiel, Thomas; Pertl, Ursula; Hess, Clemens F.; Jürgens, H.; Kościelniak, Ewa; Pötter, Richard; Heek-Romanowski, R. Van; Rossi, Rainer; Schött, Christian; Spaar, Hans-Joachim; Willnow, U; Treuner, J.

doi:10.1002/(sici)1096-911x(199805)30:5<269::aid-mpo2>3.0.co;2-d

Cited by 68 publications

(46 citation statements)

References 10 publications

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“…However, embryonal patients demonstrated superior overall survival when compared to those with alveolar histology ( P = .027). Aggressive operative therapy vs local therapy did not correlate with improved overall survival [13].…”

Section: Discussionmentioning

confidence: 74%

Outcome after surgical resection of recurrent rhabdomyosarcoma

Hayes‐Jordan

Doherty

West

et al. 2006

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 74%

Outcome after surgical resection of recurrent rhabdomyosarcoma

Hayes‐Jordan

Doherty

West

et al. 2006

Journal of Pediatric Surgery

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“…In addition, topoisomerase I and II inhibitors and platinum compounds may be administered to high risk patients or those with insufficient response. [17,18] In the CWS-81 and -86 studies, all patients received a four-drug chemotherapy regimen comprising vincristine, dactin-omycin, doxorubicin, and alkylating agent cyclophosphamide in the CWS-81 study [vincristine, dactinomycin D, doxorubicin and cyclophosphamide (VACA) Cycle] or ifosfamide in the CWS-86 Study [vincristine, dactinomycin, ifosfamide and doxorubicin (VAIA) cycle]. The replacement of cyclophosphamide by ifosfamide improved the response in patients with macroscopic residual tumor by increasing the proportion of patients with ≥two-thirds tumor volume reduction; however, no clear benefit in terms of event-free and overall survival was seen.…”

Section: Chemotherapymentioning

confidence: 99%

Soft Tissue Sarcoma in Children

2002

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Soft tissue sarcomas (STS) account for approximately 7% of malignant neoplasms in children. The heterogeneity of STS makes the diagnosis and therapy particularly difficult and should be reserved for specialized centers with expertise in treating cancer in children. Major progress in the accuracy of diagnosis and classification has been made by the identification of specific, recurring genetic alterations t(2;13)(q35;q14) and t(1;13)(p36;q14) in alveolar rhabdomyosarcomas (RMS), t(X;18)(p11;q11) for synovial sarcoma (SS) and t(11;22)(q24;q12) or t(21;22)(q22;q12) for Ewing's tumor family. As a result of large multicenter STS studies, such as the North-American Intergroup Rhabdomyosarcoma Study, the German Pediatric Soft Tissue Sarcoma Study Group (CWS), Italian Gruppo Cooperativo Italiano study and Sociètè Internationale d'Oncologie Pèdiatrique (SIOP) Malignant Mesenchymal Tumors study, the identification of more effective treatment strategies and improvement in prognosis have been made in the last 30 years. Prognostic variables were identified and, by exploring novel therapeutic strategies, criteria were established for the use of preoperative chemotherapy and radiotherapy, and primary and delayed second-look surgery. As a result of evaluation of different drugs active in STS, refinements in the utilization of chemotherapy have been made possible. Clinical trials have also been instrumental in defining the late effects of treatment. In STS the following drugs have proven to be useful: dactinomycin, vincristine, alkylating agents such as cyclophosphamide and ifosfamide, as well as anthracyclines such as doxorubicin (adriamycin) and epi-doxorubicin. Recommendations for radiation are dependent on the primary site and size of the tumour, histology, patient age and the extent of disease before and after surgical resection. In general, with conventional fractionation (1 x 1.8 to 2 Gy/day) radiotherapy doses between 40 and 50 Gy should be administered. The German CWS group explored the effectiveness of 32 Gy when accelerated and hyperfractionated, and given simultaneously to chemotherapy, and found it adequate for local tumor control in patients with selected favorable prognostic factors. When treated with a combination of chemotherapy and local therapy, STS showed an event-free survival between 50 and 80% [RMS 70%, extraskeletal Ewing sarcoma (EES) and peripheral neuroectodermal tumor (PNET) circa 50%, and SS 70 to 80%]. About one-fifth of patients with newly diagnosed RMS-like STS have metastatic disease. The 5-year survival rate among these patients is low (20 to 30%). Age (>10 years), bone, and/or bone marrow metastases are associated with a very poor prognosis (survival rate of about 5%). The value of high dose chemotherapy with hematopoietic stem cell rescue in patients with poor prognostic STS remains unclear and should be performed in controlled studies only.

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“…Responses to the combination of a platinating agent with etoposide have been reported for a variety of pediatric tumors, including medulloblastoma,1-4 neuroblastoma,5-7 Wilms tumor,8,9 germ cell tumor,10,11 rhabdomyosarcoma,9,12,13 and retinoblastoma 14. Carboplatin, which is much less ototoxic15-18 and nephrotoxic19-21 than cisplatin, is now used to treat many pediatric tumors.…”

Section: Introductionmentioning

confidence: 99%

Phase 1 study of an oxaliplatin and etoposide regimen in pediatric patients with recurrent solid tumors

McGregor

Spunt

Santana

et al. 2009

Cancer

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A novel all‐polymer light modulator with a gel‐in‐gel system was developed. The gel‐in‐gel system was constructed with colored gel particles responsive to stimuli held independently in another stimuli‐nonresponsive gel matrix. Well‐known thermoresponsive N‐isopropylacrylamide (NIPAM) gel particles containing a pigment were dispersed and fixed in an outer stimuli‐nonresponsive gel matrix. When poly(vinyl alcohol)–styrylpyridinium (PVA–SbQ) was used for the outer gel matrix, the light modulator showed excellent color‐changing properties because the PVA–SbQ matrix was selectively formed around the NIPAM gel particles and the particles exhibited a large volume change in the matrix. The temperature when the outer gel matrix was formed affected the haze of the light modulator. When the outer gel matrix was formed in the swollen state of the NIPAM gels, the haze of a light modulator increased with heating. On the contrary, the haze of a light modulator prepared in the shrunken state of the NIPAM gels decreased with heating. The response time of the color change was less than 1 s. The gel‐in‐gel system made a very fast macroscopic color change, taking advantage of the fast response of the micrometer‐sized gel particles. We believe that a light modulator with a gel‐in‐gel system may find various applications in optical devices. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 103: 2295–2303, 2007

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Treatment of children with relapsed soft tissue sarcoma: Report of the German CESS/CWS REZ 91 Trial

Cited by 68 publications

References 10 publications

Outcome after surgical resection of recurrent rhabdomyosarcoma

Outcome after surgical resection of recurrent rhabdomyosarcoma

Soft Tissue Sarcoma in Children

Phase 1 study of an oxaliplatin and etoposide regimen in pediatric patients with recurrent solid tumors

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