This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Koscielniak, E. Articles by Treuner, J. Search for Related Content PubMed PubMed Citation Articles by Koscielniak, E. Articles by Treuner, J. Social Bookmarking                            What's this?

Results of Treatment for Soft Tissue Sarcoma in Childhood and Adolescence: A Final Report of the German Cooperative Soft Tissue Sarcoma Study CWS-86

From the Department of Oncology/Haematology, Olga Hospital, Stuttgart; Institute of Paidopathology, University of Kiel, Kiel; Charite-Virchow-Klinikum, Berlin; University Children's Hospital, Düsseldorf; Department of Radiology, University of Regensburg, Regensburg; Department of Oncology/Haematology, University of Tübingen, Tübingen; Department of Radiotherapy, Katharinen Hospital, Stuttgart, Germany; and St Anna Kinderspital, Vienna, Austria.

Address reprint requests to Ewa Koscielniak, MD, Department of Oncology/Haematology, Olga Hospital, Bismarckstrasse 8, D-70176 Stuttgart 1, Germany; email cws.study{at}olgahospital.s.shuttle.de

PURPOSE: The goal of the second German Soft Tissue Sarcoma Study CWS-86 (1985 to 1990) was to improve the prognosis in children and adolescents with soft tissue sarcoma by means of a clinical trial comprising intensive chemotherapy and risk-adapted local therapy.

PATIENTS AND METHODS: There were 372 eligible patients. A staging system based on the postsurgical extent of disease was used. Chemotherapy consisted of vincristine, dactinomycin, doxorubicin, and ifosfamide. Radiotherapy was administered early at 10 to 13 weeks simultaneously with the second chemotherapy cycle (32 Gy or 54.4 Gy). The single dose was reduced to 1.6 Gy and given twice daily (accelerated hyperfractionation).

RESULTS: The event-free survival (EFS) and overall survival rates at 5 years were 59% ± 3% and 69% ± 3%, respectively. The 5-year EFS rate according to stage was as follows: stage I, 83% ± 5%; stage II, 69% ± 6%; stage III, 57% ± 4%; and stage IV, 19% ± 6%. The outcome for patients with stage III disease who required radiotherapy was much better in the CWS-86 study compared with the CWS-81 study (5-year EFS, 60% ± 5% v 44% ± 6%; P = .053). The most common treatment failure was isolated local relapse, with 14% of patients relapsing at the primary tumor site.

CONCLUSION: The improved design of the study incorporating risk-adapted radiotherapy allowed treatment to be reduced for selected groups of patients without compromising survival.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. Oesch, D. Walter, M. Wachtel, K. Pretre, M. Salazar, M. Guzman, G. Velasco, and B. W. Schafer Cannabinoid receptor 1 is a potential drug target for treatment of translocation-positive rhabdomyosarcoma Mol. Cancer Ther., July 1, 2009; 8(7): 1838 - 1845. [Abstract] [Full Text] [PDF]

				T. M. Dantonello, C. Int-Veen, D. Harms, I. Leuschner, B. F. Schmidt, M. Herbst, H. Juergens, H.-G. Scheel-Walter, S. S. Bielack, T. Klingebiel, et al. Cooperative Trial CWS-91 for Localized Soft Tissue Sarcoma in Children, Adolescents, and Young Adults J. Clin. Oncol., March 20, 2009; 27(9): 1446 - 1455. [Abstract] [Full Text] [PDF]

				O. Oberlin, A. Rey, E. Lyden, G. Bisogno, M. C.G. Stevens, W. H. Meyer, M. Carli, and J. R. Anderson Prognostic Factors in Metastatic Rhabdomyosarcomas: Results of a Pooled Analysis From United States and European Cooperative Groups J. Clin. Oncol., May 10, 2008; 26(14): 2384 - 2389. [Abstract] [Full Text] [PDF]

				T. M. Dantonello, C. Int-Veen, P. Winkler, I. Leuschner, A. Schuck, B. F. Schmidt, H. Lochbuehler, S. Kirsch, E. Hallmen, I. Veit-Friedrich, et al. Initial Patient Characteristics Can Predict Pattern and Risk of Relapse in Localized Rhabdomyosarcoma J. Clin. Oncol., January 20, 2008; 26(3): 406 - 413. [Abstract] [Full Text] [PDF]

				T. Volker, T. Denecke, I. Steffen, D. Misch, S. Schonberger, M. Plotkin, J. Ruf, C. Furth, B. Stover, H. Hautzel, et al. Positron Emission Tomography for Staging of Pediatric Sarcoma Patients: Results of a Prospective Multicenter Trial J. Clin. Oncol., December 1, 2007; 25(34): 5435 - 5441. [Abstract] [Full Text] [PDF]

				M. Burke, J. R. Anderson, S. C. Kao, D. Rodeberg, S. J. Qualman, S. L. Wolden, W. H. Meyer, and P. P. Breitfeld Assessment of Response to Induction Therapy and Its Influence on 5-Year Failure-Free Survival in Group III Rhabdomyosarcoma: The Intergroup Rhabdomyosarcoma Study-IV Experience A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group J. Clin. Oncol., November 1, 2007; 25(31): 4909 - 4913. [Abstract] [Full Text] [PDF]

				C. D. Toma, M. Dominkus, M. Pfeiffer, P. Giovanoli, O. Assadian, and R. Kotz Metatarsal Reconstruction with Use of Free Vascularized Osteomyocutaneous Fibular Grafts Following Resection of Malignant Tumors of the Midfoot. A Series of Six Cases J. Bone Joint Surg. Am., July 1, 2007; 89(7): 1553 - 1564. [Abstract] [Full Text] [PDF]

				J. L. Meza, J. Anderson, A. S. Pappo, and W. H. Meyer Analysis of Prognostic Factors in Patients With Nonmetastatic Rhabdomyosarcoma Treated on Intergroup Rhabdomyosarcoma Studies III and IV: The Children's Oncology Group J. Clin. Oncol., August 20, 2006; 24(24): 3844 - 3851. [Abstract] [Full Text] [PDF]

				M. Wachtel, T. Runge, I. Leuschner, S. Stegmaier, E. Koscielniak, J. Treuner, B. Odermatt, S. Behnke, F. K. Niggli, and B. W. Schafer Subtype and Prognostic Classification of Rhabdomyosarcoma by Immunohistochemistry J. Clin. Oncol., February 10, 2006; 24(5): 816 - 822. [Abstract] [Full Text] [PDF]

				M. C.G. Stevens, A. Rey, N. Bouvet, C. Ellershaw, F. Flamant, J. L. Habrand, H. B. Marsden, H. Martelli, J. S. de Toledo, R. D Spicer, et al. Treatment of Nonmetastatic Rhabdomyosarcoma in Childhood and Adolescence: Third Study of the International Society of Paediatric Oncology--SIOP Malignant Mesenchymal Tumor 89 J. Clin. Oncol., April 20, 2005; 23(12): 2618 - 2628. [Abstract] [Full Text] [PDF]

				M. Wachtel, M. Dettling, E. Koscielniak, S. Stegmaier, J. Treuner, K. Simon-Klingenstein, P. Buhlmann, F. K. Niggli, and B. W. Schafer Gene Expression Signatures Identify Rhabdomyosarcoma Subtypes and Detect a Novel t(2;2)(q35;p23) Translocation Fusing PAX3 to NCOA1 Cancer Res., August 15, 2004; 64(16): 5539 - 5545. [Abstract] [Full Text] [PDF]

				M. D. Wharam, J. Meza, J. Anderson, J. C. Breneman, S. S. Donaldson, T. J. Fitzgerald, J. Michalski, L. A. Teot, E. S. Wiener, and W. H. Meyer Failure Pattern and Factors Predictive of Local Failure in Rhabdomyosarcoma: A Report of Group III Patients on the Third Intergroup Rhabdomyosarcoma Study J. Clin. Oncol., May 15, 2004; 22(10): 1902 - 1908. [Abstract] [Full Text] [PDF]

				A. Schuck, A. C. Mattke, B. Schmidt, D. S. Kunz, D. Harms, R. Knietig, J. Treuner, and E. Koscielniak Group II Rhabdomyosarcoma and Rhabdomyosarcomalike Tumors: Is Radiotherapy Necessary? J. Clin. Oncol., January 1, 2004; 22(1): 143 - 149. [Abstract] [Full Text] [PDF]

				N. Germann, F. Goffinet, and F. Goldwasser Anthracyclines during pregnancy: embryo-fetal outcome in 160 patients Ann. Onc., January 1, 2004; 15(1): 146 - 150. [Abstract] [Full Text] [PDF]

				A. S. Pappo, J. L. Meza, S. S. Donaldson, M. D. Wharam, E. S. Wiener, S. J. Qualman, H. M. Maurer, and W. M. Crist Treatment of Localized Nonorbital, Nonparameningeal Head and Neck Rhabdomyosarcoma: Lessons Learned From Intergroup Rhabdomyosarcoma Studies III and IV J. Clin. Oncol., February 15, 2003; 21(4): 638 - 645. [Abstract] [Full Text] [PDF]

				W. M. Crist, J. R. Anderson, J. L. Meza, C. Fryer, R. B. Raney, F. B. Ruymann, J. Breneman, S. J. Qualman, E. Wiener, M. Wharam, et al. Intergroup Rhabdomyosarcoma Study-IV: Results for Patients With Nonmetastatic Disease J. Clin. Oncol., June 15, 2001; 19(12): 3091 - 3102. [Abstract] [Full Text] [PDF]

				H. E. Grier Soft Tissue Sarcoma: Apples, Oranges, and Passion Fruit J. Clin. Oncol., December 1, 1999; 17(12): 3695 - 3696. [Full Text] [PDF]