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Title: Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors

Abstract

Purpose: To identify the prognostic role of adjuvant abdominal radiation therapy (RT) on oncologic outcomes as a part of multimodal treatment in the management of desmoplastic small round cell tumor (DSRCT) and to determine its impact according to the quality of surgical resection. Methods and Materials: All patients treated for primary abdominal DSRCT in 8 French centers from 1991 to 2014 were included. Patients were retrospectively staged into 3 groups: group A treated with adjuvant RT after cytoreductive surgery, group B without RT after cytoreductive surgery, and group C by exclusive chemotherapy. Peritoneal progression-free survival (PPFS), progression-free survival (PFS), and overall survival (OS) were evaluated. We also performed a direct comparison between groups A and B to evaluate RT after cytoreductive surgery. Radiation therapy was also evaluated according to completeness of surgery: complete cytoreductive surgery (CCS) or incomplete cytoreductive surgery (ICS). Results: Thirty-seven (35.9%), thirty-six (34.9%), and thirty (28.0%) patients were included in groups A, B, and C, respectively. Three-year OS was 61.2% (range, 41.0%-76.0%), 37.6% (22.0%-53.1%), and 17.3% (6.3%-32.8%) for groups A, B, and C, respectively. Overall survival, PPFS, and PFS differed significantly among the 3 groups (P<.001, P<.001, and P<.001, respectively). Overall survival and PPFS were higher inmore » group A (RT group) compared with group B (no RT group) (P=.045 and P=.006, respectively). Three-year PPFS was 23.8% (10.3%-40.4%) for group A and 12.51% (4.0%-26.2%) for group B. After CCS, RT improved PPFS (P=.024), but differences in OS and PFS were not significant (P=.40 and P=.30, respectively). After ICS, RT improved OS (P=.044). A trend of PPFS and PFS increase was observed, but the difference was not statistically significant (P=.073 and P=.076). Conclusions: Adjuvant RT as part of multimodal treatment seems to confer oncologic benefits for patients treated for abdominal DSRCT after cytoreductive surgery and perioperative chemotherapy.« less

Authors:
 [1];  [2]; ;  [3];  [4];  [1];  [5];  [6];  [7];  [8];  [1];  [9]; ;  [1];  [10];  [1]
  1. Department of Radiation Oncology, Bergonie Institute, Bordeaux (France)
  2. Department of Digestive Surgery, Gustave-Roussy Institute, Paris (France)
  3. Department of Pediatric Oncology, Curie Institute, Paris (France)
  4. Department of Radiation Oncology, Universitary Cancer Institute, Toulouse (France)
  5. Department of Radiation Oncology, Alexis-Vautrin Center, Nancy (France)
  6. Department of Radiation Oncology, Cancerologie de l'ouest Institute, Nantes (France)
  7. Department of Radiation Oncology, Paoli-Calmette Institute, Marseille (France)
  8. Department of Radiation Oncology, Universitary Hospital, Bordeaux (France)
  9. Department of Pediatric Surgery, University Paris 7 Denis Diderot, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris (France)
  10. Department of Radiation Oncology, Leon-Berard Center, Lyon (France)
Publication Date:
OSTI Identifier:
22648742
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 4; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; NEOPLASMS; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats

Atallah, Vincent, Honore, Charles, Orbach, Daniel, Helfre, Sylvie, Ducassou, Anne, Thomas, Laurence, Levitchi, Mihai-Barbu, Mervoyer, Augustin, Naji, Salem, Dupin, Charles, Bosco-Levy, Pauline J., Philippe-Chomette, Pascale, Kantor, Guy, Henriques de Figueiredo, Benedicte, Sunyach, Marie-Pierre, and Sargos, Paul, E-mail: p.sargos@bordeaux.unicancer.fr. Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.02.046.
Atallah, Vincent, Honore, Charles, Orbach, Daniel, Helfre, Sylvie, Ducassou, Anne, Thomas, Laurence, Levitchi, Mihai-Barbu, Mervoyer, Augustin, Naji, Salem, Dupin, Charles, Bosco-Levy, Pauline J., Philippe-Chomette, Pascale, Kantor, Guy, Henriques de Figueiredo, Benedicte, Sunyach, Marie-Pierre, & Sargos, Paul, E-mail: p.sargos@bordeaux.unicancer.fr. Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors. United States. doi:10.1016/J.IJROBP.2016.02.046.
Atallah, Vincent, Honore, Charles, Orbach, Daniel, Helfre, Sylvie, Ducassou, Anne, Thomas, Laurence, Levitchi, Mihai-Barbu, Mervoyer, Augustin, Naji, Salem, Dupin, Charles, Bosco-Levy, Pauline J., Philippe-Chomette, Pascale, Kantor, Guy, Henriques de Figueiredo, Benedicte, Sunyach, Marie-Pierre, and Sargos, Paul, E-mail: p.sargos@bordeaux.unicancer.fr. Fri . "Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors". United States. doi:10.1016/J.IJROBP.2016.02.046.
@article{osti_22648742,
title = {Role of Adjuvant Radiation Therapy After Surgery for Abdominal Desmoplastic Small Round Cell Tumors},
author = {Atallah, Vincent and Honore, Charles and Orbach, Daniel and Helfre, Sylvie and Ducassou, Anne and Thomas, Laurence and Levitchi, Mihai-Barbu and Mervoyer, Augustin and Naji, Salem and Dupin, Charles and Bosco-Levy, Pauline J. and Philippe-Chomette, Pascale and Kantor, Guy and Henriques de Figueiredo, Benedicte and Sunyach, Marie-Pierre and Sargos, Paul, E-mail: p.sargos@bordeaux.unicancer.fr},
abstractNote = {Purpose: To identify the prognostic role of adjuvant abdominal radiation therapy (RT) on oncologic outcomes as a part of multimodal treatment in the management of desmoplastic small round cell tumor (DSRCT) and to determine its impact according to the quality of surgical resection. Methods and Materials: All patients treated for primary abdominal DSRCT in 8 French centers from 1991 to 2014 were included. Patients were retrospectively staged into 3 groups: group A treated with adjuvant RT after cytoreductive surgery, group B without RT after cytoreductive surgery, and group C by exclusive chemotherapy. Peritoneal progression-free survival (PPFS), progression-free survival (PFS), and overall survival (OS) were evaluated. We also performed a direct comparison between groups A and B to evaluate RT after cytoreductive surgery. Radiation therapy was also evaluated according to completeness of surgery: complete cytoreductive surgery (CCS) or incomplete cytoreductive surgery (ICS). Results: Thirty-seven (35.9%), thirty-six (34.9%), and thirty (28.0%) patients were included in groups A, B, and C, respectively. Three-year OS was 61.2% (range, 41.0%-76.0%), 37.6% (22.0%-53.1%), and 17.3% (6.3%-32.8%) for groups A, B, and C, respectively. Overall survival, PPFS, and PFS differed significantly among the 3 groups (P<.001, P<.001, and P<.001, respectively). Overall survival and PPFS were higher in group A (RT group) compared with group B (no RT group) (P=.045 and P=.006, respectively). Three-year PPFS was 23.8% (10.3%-40.4%) for group A and 12.51% (4.0%-26.2%) for group B. After CCS, RT improved PPFS (P=.024), but differences in OS and PFS were not significant (P=.40 and P=.30, respectively). After ICS, RT improved OS (P=.044). A trend of PPFS and PFS increase was observed, but the difference was not statistically significant (P=.073 and P=.076). Conclusions: Adjuvant RT as part of multimodal treatment seems to confer oncologic benefits for patients treated for abdominal DSRCT after cytoreductive surgery and perioperative chemotherapy.},
doi = {10.1016/J.IJROBP.2016.02.046},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 95,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}