PMID- 21761400 OWN - NLM STAT- MEDLINE DCOM- 20120416 LR - 20211020 IS - 1097-0142 (Electronic) IS - 0008-543X (Print) IS - 0008-543X (Linking) VI - 118 IP - 4 DP - 2012 Feb 15 TI - Patterns of chemotherapy-induced toxicities in younger children and adolescents with rhabdomyosarcoma: a report from the Children's Oncology Group Soft Tissue Sarcoma Committee. PG - 1130-7 LID - 10.1002/cncr.26358 [doi] AB - BACKGROUND: Patients aged >10 years with rhabdomyosarcoma have an inferior outcome compared with patients ages 1 to 9 years, which may be explained by toxicities (adverse events [AEs]) that result in chemotherapy dose reductions. METHODS: AEs observed during 1 of 3 randomized chemotherapy regimens (vincristine, dactinomycin, and cyclophosphamide [VAC]; vincristine, dactinomycin, and ifosfamide [VAI]; or vincristine, ifosfamide, and etoposide [VIE]) in the Fourth Intergroup Rhabdomyosarcoma Study were recorded. The incidence of toxicities by age and treatment regimen was determined. The odds of developing AEs in a particular age group (ages 5-9 years, 10-14 years, and 15-20 years) were compared with the odds in the control group of patients ages 1 to 4 years. RESULTS: In total, 657 patients were eligible for analysis. The estimated 5-year event-free survival rates were 78%, 83%, 67%, and 58% for the groups ages 1 to 4 years, 5 to 9 years, 10 to 14 years, and 15 to 20 years, respectively. Patients ages 15 to 20 years experienced less neutropenia (odds ratio [OR], 0.43; P < .0001), thrombocytopenia (OR, 0.41; P < .0001), anemia (OR, 0.34; P < .0001), and infection (OR, 0.41; P < .0001) compared with younger patients, although they received similar amounts of chemotherapy. In contrast, peripheral nervous system toxicity was higher in adolescents aged >10 years (OR, 4.18; P < .0001). Females experienced more neutropenia (OR, 1.28; P = .05) and thrombocytopenia (OR, 1.26; P = .06) compared with males. CONCLUSIONS: Adolescents who received treatment for rhabdomyosarcoma experienced significantly less hematologic toxicity and more peripheral nervous system toxicity compared with younger children despite receiving similar amounts of chemotherapy. Although outcomes were inferior in adolescents, it was unclear whether the differences in toxicity observed in the current study had an impact on outcome. The authors concluded that future studies examining the age-related and sex-related differences in pharmacokinetics of chemotherapy are necessary. CI - Copyright (c) 2011 American Cancer Society. FAU - Gupta, Abha A AU - Gupta AA AD - Department of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. abha.gupta@sickkids.ca FAU - Anderson, James R AU - Anderson JR FAU - Pappo, Alberto S AU - Pappo AS FAU - Spunt, Sheri L AU - Spunt SL FAU - Dasgupta, Roshni AU - Dasgupta R FAU - Indelicato, Daniel J AU - Indelicato DJ FAU - Hawkins, Douglas S AU - Hawkins DS LA - eng GR - U10 CA072989/CA/NCI NIH HHS/United States GR - U10 CA024507-26/CA/NCI NIH HHS/United States GR - U10 CA24507/CA/NCI NIH HHS/United States GR - U10 CA024507-24/CA/NCI NIH HHS/United States GR - U10 CA098413/CA/NCI NIH HHS/United States GR - U10 CA098413-05/CA/NCI NIH HHS/United States GR - U10 CA072989-03/CA/NCI NIH HHS/United States GR - U10 CA024507-23/CA/NCI NIH HHS/United States GR - U10 CA98543-08/CA/NCI NIH HHS/United States GR - U10 CA024507-22/CA/NCI NIH HHS/United States GR - U10 CA072989-04/CA/NCI NIH HHS/United States GR - U10 CA072989-05/CA/NCI NIH HHS/United States GR - U10 CA024507-25/CA/NCI NIH HHS/United States GR - U10 CA072989-06/CA/NCI NIH HHS/United States GR - U10 CA98413-08/CA/NCI NIH HHS/United States GR - L40 CA103665/CA/NCI NIH HHS/United States GR - U10 CA098543/CA/NCI NIH HHS/United States GR - U10 CA024507/CA/NCI NIH HHS/United States GR - U10 CA098413-04/CA/NCI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20110714 PL - United States TA - Cancer JT - Cancer JID - 0374236 RN - 1CC1JFE158 (Dactinomycin) RN - 3Z8479ZZ5X (Epirubicin) RN - 5J49Q6B70F (Vincristine) RN - 80168379AG (Doxorubicin) RN - 8N3DW7272P (Cyclophosphamide) RN - NR7O1405Q9 (Mesna) RN - UM20QQM95Y (Ifosfamide) RN - VAC protocol RN - VAIA protocol RN - VIE protocol SB - IM MH - Adolescent MH - Age Factors MH - Anemia/chemically induced/*epidemiology MH - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects/*therapeutic use MH - Child MH - Child, Preschool MH - Cyclophosphamide/administration & dosage MH - Dactinomycin/administration & dosage MH - Doxorubicin/administration & dosage MH - Epirubicin/administration & dosage MH - Female MH - Humans MH - Ifosfamide/administration & dosage MH - Incidence MH - Male MH - Mesna/administration & dosage MH - Neutropenia/chemically induced/*epidemiology MH - Rhabdomyosarcoma/*drug therapy MH - Sex Characteristics MH - Survival Rate MH - Thrombocytopenia/chemically induced/*epidemiology MH - Vincristine/administration & dosage MH - Young Adult PMC - PMC4008942 MID - NIHMS304502 EDAT- 2011/07/16 06:00 MHDA- 2012/04/17 06:00 PMCR- 2014/05/03 CRDT- 2011/07/16 06:00 PHST- 2011/04/20 00:00 [received] PHST- 2011/05/18 00:00 [revised] PHST- 2011/05/24 00:00 [accepted] PHST- 2011/07/16 06:00 [entrez] PHST- 2011/07/16 06:00 [pubmed] PHST- 2012/04/17 06:00 [medline] PHST- 2014/05/03 00:00 [pmc-release] AID - 10.1002/cncr.26358 [doi] PST - ppublish SO - Cancer. 2012 Feb 15;118(4):1130-7. doi: 10.1002/cncr.26358. Epub 2011 Jul 14.