Long‐term outcome evaluation of medium/high risk acute lymphoblastic leukaemia children treated with or without cranial radiotherapy in the EORTC 58832 randomized study

Autor: Françoise Mazingue, Nicolas Sirvent, Robert Paulus, Pierre Philippet, Caroline Piette, Maryline Poirée, Jutte van der Werff ten Bosch, Claire Freycon, Pauline Simon, Claire Hoyoux, Yves Benoit, Catherine Paillard, Yves Bertrand, Claire Pluchart, Geneviève Plat, Caroline Thomas, Anne Uyttebroeck, Stefan Suciu, Pierre Rohrlich, Renée Maurus, Caroline Gilotay, Alina Ferster, Els Vandecruys
Přispěvatelé: Centre Hospitalier Universitaire de Liège (CHU-Liège), European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, University Hospitals Leuven [Leuven], Ghent University Hospital, CHU Toulouse [Toulouse], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Paediatric Department [Bruxelles, Belgique], Université libre de Bruxelles (ULB)-Hôpital Universitaire des Enfants Reine Fabiola [Bruxelles, Belgique] (HUDERF), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Universitaire des Enfants Reine Fabiola [Bruxelles, Belgique] (HUDERF), Service de Pédiatrie [CHR de la Citadelle, Liège, Belgium], Centre Hospitalier Régional de la Citadelle [Liège, Belgium] (CHR de la Citadelle), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Saint-Pierre Hospital (Department of Paediatric Onco-Haematology), Centre Hospitalier PELTZER-LA TOURELLE [Verviers, Belgium], Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Hématologie et oncologie pédiatrique, Centre hospitalier universitaire de Nantes (CHU Nantes), Universitair Ziekenhuis [Brussels, Belgium], Service d'hématologie, Clinical sciences, Growth and Development, Pediatrics
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
ADULT SURVIVORS
Gastroenterology
THERAPY
law.invention
0302 clinical medicine
Randomized controlled trial
law
cranial irradiation
ENDOCRINE
Child
Medicine(all)
Incidence (epidemiology)
Hazard ratio
Hematology
Precursor Cell Lymphoblastic Leukemia-Lymphoma
CHEMOTHERAPY
3. Good health
Treatment Outcome
TRIALS
Child
Preschool
030220 oncology & carcinogenesis
Female
Life Sciences & Biomedicine
NEOPLASMS
Adult
medicine.medical_specialty
Adolescent
[SDV.CAN]Life Sciences [q-bio]/Cancer
Young Adult
03 medical and health sciences
childhood ALL
Internal medicine
medicine
Humans
late effects
GROWTH-HORMONE-SECRETION
Adverse effect
Survival rate
Science & Technology
Cranial radiotherapy
CHILDHOOD-CANCER
business.industry
Confidence interval
Lymphoblastic leukaemia
business
survivorship
second neoplasm
030215 immunology
Hématologie
Zdroj: British Journal of Haematology
British Journal of Haematology, Wiley, 2019, ⟨10.1111/bjh.16337⟩
British journal of haematology
ISSN: 0007-1048
1365-2141
Popis: We investigated the long-term outcome, the incidence of second neoplasms (SN) and the rate of late adverse effects (LAE) in children with central nervous system (CNS) negative medium/high-risk de novo acute lymphoblastic leukaemia (ALL), in first complete remission (CR1) at end of late intensification, randomized to receive no cranial radiotherapy (No CRT, n = 92) versus CRT (standard arm, n = 84) in the non-inferiority EORTC 58832 study (1983–1989). Median follow-up was 20 years (range 4–32 years). The 25-year disease-free survival rate (±SE) was 67·4 ± 4·9% without CRT and 70·2 ± 5·0% with CRT. The 25-year incidence of isolated (6·5 ± 2·6% vs. 4·8 ± 2·3%) and any CNS relapse {8·7 ± 2·9% vs. 11·9 ± 3·5%; hazard ratio (HR) 0·71 [95% confidence interval (CI) 0·28–1·79]; test of non-inferiority: P = 0·01} was not increased without CRT. The 25-year SN incidence in CR1 was 7·9 ± 4·6% vs. 11·0 ± 4·2%. The 25-year event-free and overall survival rates were quite similar in both arms [59·5 ± 6·3% vs. 60·5 ± 5·9%, HR 0·94 (95% CI 0·57–1·52), and 78·1 ± 4·3% vs. 78·5 ± 4·5%, HR 1·00 (95% CI 0·53–1·88)]. Omission of CRT was associated with dramatic decrease in CNS and endocrine LAE rates. In conclusion, our data suggest that, with proper systemic and intrathecal CNS prophylaxis, CRT could totally be omitted in CR1 without jeopardizing survival, while decreasing LAE in childhood ALL.
SCOPUS: ar.j
info:eu-repo/semantics/published
Databáze: OpenAIRE
Externí odkaz: