TY - JOUR
T1 - Impact of Rhabdomyosarcoma Treatment Modalities by Age in a Population-Based Setting
AU - Ferrari, Andrea
AU - Bernasconi, Alice
AU - Bergamaschi, Luca
AU - Botta, Laura
AU - Andreano, Anita
AU - Castaing, Marine
AU - Rugge, Massimo
AU - Bisogno, Gianni
AU - Falcini, Fabio
AU - Sacerdote, Carlotta
AU - Tagliabue, Giovanna
AU - Michiara, Maria
AU - Cirilli, Claudia
AU - Barchielli, Alessandro
AU - Filiberti, Rosa Angela
AU - Vitale, Maria Francesca
AU - Tumino, Rosario
AU - Stracci, Fabrizio
AU - Chiaravalli, Stefano
AU - Casanova, Michela
AU - Gasparini, Patrizia
AU - Milano, Giuseppe Maria
AU - Gatta, Gemma
AU - Trama, Annalisa
PY - 2020
Y1 - 2020
N2 - Purpose:Rhabdomyosarcoma (RMS) has a worse prognosis in adults than in children, but there is evidence of a better outcome in the former if treated using a pediatric-like approach. This study describes treatment for RMS in patients more than 10 years old and examines to what extent treatment contributes to explain the different age-related survival observed and to what extent treatment centers impact treatment appropriateness. Methods:A retrospective population-based study was developed considering 104 RMS cases (excluding the pleomorphic subtype) diagnosed in Italy between 2000 and 2015. Patients were grouped by age (10-19 vs. 20-60 years old) and scored according to whether or not their chemotherapy was consistent with the schemes used in pediatric protocols (score 1 = chemotherapy in line with pediatric protocols). Treatment centers were grouped according to whether or not they have a pediatric-dedicated unit affiliated to the national pediatric oncology network (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]). Results:Older patients were more likely to have tumors at unfavorable sites (p = 0.045). A treatment score of 1 was assigned to 85% of younger patients, but only to 32% of older patients (p <0.001). Furthermore, the proportion of score 1 was higher in younger patients treated in centers with an AIEOP Unit. A multivariate model confirmed age as a significant prognostic factor (Hazard rate ratio [HR] = 2.06;p = 0.04) and showed a significant impact of treatment on survival (HR = 2.13;p = 0.03). Conclusions:Adult RMS patients are still relatively unlikely to be treated with pediatric protocols and in centers with a pediatric oncology expertise. This may explain the survival gap between older and younger patients.
AB - Purpose:Rhabdomyosarcoma (RMS) has a worse prognosis in adults than in children, but there is evidence of a better outcome in the former if treated using a pediatric-like approach. This study describes treatment for RMS in patients more than 10 years old and examines to what extent treatment contributes to explain the different age-related survival observed and to what extent treatment centers impact treatment appropriateness. Methods:A retrospective population-based study was developed considering 104 RMS cases (excluding the pleomorphic subtype) diagnosed in Italy between 2000 and 2015. Patients were grouped by age (10-19 vs. 20-60 years old) and scored according to whether or not their chemotherapy was consistent with the schemes used in pediatric protocols (score 1 = chemotherapy in line with pediatric protocols). Treatment centers were grouped according to whether or not they have a pediatric-dedicated unit affiliated to the national pediatric oncology network (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]). Results:Older patients were more likely to have tumors at unfavorable sites (p = 0.045). A treatment score of 1 was assigned to 85% of younger patients, but only to 32% of older patients (p <0.001). Furthermore, the proportion of score 1 was higher in younger patients treated in centers with an AIEOP Unit. A multivariate model confirmed age as a significant prognostic factor (Hazard rate ratio [HR] = 2.06;p = 0.04) and showed a significant impact of treatment on survival (HR = 2.13;p = 0.03). Conclusions:Adult RMS patients are still relatively unlikely to be treated with pediatric protocols and in centers with a pediatric oncology expertise. This may explain the survival gap between older and younger patients.
KW - ONCOLOGIA
KW - ARTICOLO
KW - RIS
U2 - 10.1089/jayao.2020.0043
DO - 10.1089/jayao.2020.0043
M3 - Article
JO - J. Adolesc. Young Adult Oncol.
JF - J. Adolesc. Young Adult Oncol.
SN - 2156-5333
ER -