The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma
Abstract 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 eva...
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Wiley
2019-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2002 |
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| author | Lianne M. Haveman Andreas Ranft Henk vd Berg Anne Smets Jarmila Kruseova Ruth Ladenstein Benedicte Brichard Michael Paulussen Thomas Kuehne Heribert Juergens Stephanie Klco‐Brosius Uta Dirksen Johannes H.M. Merks |
| author_facet | Lianne M. Haveman Andreas Ranft Henk vd Berg Anne Smets Jarmila Kruseova Ruth Ladenstein Benedicte Brichard Michael Paulussen Thomas Kuehne Heribert Juergens Stephanie Klco‐Brosius Uta Dirksen Johannes H.M. Merks |
| author_sort | Lianne M. Haveman |
| collection | DOAJ |
| description | Abstract 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 | Article |
| id | doaj-art-7f86d4ae00854e7eb6be53ad597ae792 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-7f86d4ae00854e7eb6be53ad597ae7922025-01-31T08:47:43ZengWileyCancer Medicine2045-76342019-03-01831086109410.1002/cam4.2002The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing SarcomaLianne M. Haveman0Andreas Ranft1Henk vd Berg2Anne Smets3Jarmila Kruseova4Ruth Ladenstein5Benedicte Brichard6Michael Paulussen7Thomas Kuehne8Heribert Juergens9Stephanie Klco‐Brosius10Uta Dirksen11Johannes H.M. Merks12Emma Children's Hospital Department of Pediatric Oncology Academic Medical Center Amsterdam The NetherlandsDepartment of Pediatric Hematology and Oncology University of Essen Essen GermanyEmma Children's Hospital Department of Pediatric Oncology Academic Medical Center Amsterdam The NetherlandsDepartment of Radiology Academic Medical Center Amsterdam The NetherlandsDepartment of Pediatric Oncology University Hospital Motol Prague Czech RepublicChildren's Cancer Research Institute Vienna AustriaSaint Luc University Hospital Department of Pediatric Hematology and Oncology University of Louvain Datteln BelgiumWitten/Herdecke University Vestische Kinder‐ und Jugendklinik, Datteln GermanyDepartment of Pediatric Oncology and Haematology University Children Hospital Basel SwitzerlandCoordinating Center for Clinical Trials Muenster GermanyDepartment of Pediatric Hematology and Oncology University of Essen Essen GermanyDepartment of Pediatric Hematology and Oncology University of Essen Essen GermanyEmma Children's Hospital Department of Pediatric Oncology Academic Medical Center Amsterdam The NetherlandsAbstract 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.https://doi.org/10.1002/cam4.2002Ewing SarcomahistologyMRIoutcomeradiological responsetumor volume response |
| spellingShingle | Lianne M. Haveman Andreas Ranft Henk vd Berg Anne Smets Jarmila Kruseova Ruth Ladenstein Benedicte Brichard Michael Paulussen Thomas Kuehne Heribert Juergens Stephanie Klco‐Brosius Uta Dirksen Johannes H.M. Merks The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma Cancer Medicine Ewing Sarcoma histology MRI outcome radiological response tumor volume response |
| 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 | Ewing Sarcoma histology MRI outcome radiological response tumor volume response |
| url | https://doi.org/10.1002/cam4.2002 |
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