Back to Search
Start Over
Impact of Rhabdomyosarcoma Treatment Modalities by Age in a Population-Based Setting.
- Source :
-
Journal of adolescent and young adult oncology [J Adolesc Young Adult Oncol] 2021 Jun; Vol. 10 (3), pp. 309-315. Date of Electronic Publication: 2020 Jul 30. - Publication Year :
- 2021
-
Abstract
- 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.
Details
- Language :
- English
- ISSN :
- 2156-535X
- Volume :
- 10
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of adolescent and young adult oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32758055
- Full Text :
- https://doi.org/10.1089/jayao.2020.0043