Abstract:
: Purpose: About 30%-35% of nonmetastatic and 60%-80% of metastatic Ewing Sarcoma (ES) will relapse post-treatment and outcomes after relapse continue to be poor over last several decades. Prognostic factors affecting survival after relapse of ES are also not robustly known. We present outcomes using a novel hybrid salvage protocol of four active chemotherapeutic agents in our cohort of patients after relapse of ES. Methods: This is a retrospective analysis of all consecutive relapsed ES patients treated with curative intent over 4 years (January 2012 to December 2015). All received 12-cycles of hybrid chemotherapy regimen with surgery/radiotherapy done after first 4 cycles. Event-free survival (EFS)/overall survival (OS) estimates were analyzed by Kaplan-Meier product-limit estimator. Cox regression analysis was performed to identify prognostic factors predicting outcome in relapsed ES. Results: Salvage regimen was given to 53/108 relapsed ES patients with the rest having opted for palliation upfront. Median age of the treated patients was 19 years (range: 4-40); male:female ratio was 2.7:1. Median time to first relapse was 18.8 months (range: 2.2-91). While 41/53 patients (77%) completed salvage therapy, 6 (11.3%) progressed and 6 (11.3%) abandoned treatment. Median follow-up of the study cohort is 31 months (range: 4-81). Of the analyzable cohort (n = 47), 30 (64%) had a second relapse or progression on salvage treatment. At last follow-up, 31 patients had died (including one due to toxicity and rest due to disease) and 16 patients were alive (14 with no active disease and 2 with disease). The 4-year EFS and OS are 28% and 37%, respectively, for the entire cohort. While adolescents and young adult patients (AYA) had a better survival (p-0.041), relapsed ES patients with shorter disease-free interval (DFI) (<24 months) had a poorer survival (p-0.004). The type of relapse (local or metastatic or combined) after primary treatment did not affect outcome after salvage therapy. Conclusions: We have used a novel hybrid chemotherapy protocol using four active agents in relapsed ES, which is well tolerated and shows promising results. Older age (≥15 years) and longer DFI (>24 months) portend better survival post-relapse. In our cohort of relapsed ES, AYAs fared better than others and type of relapse after primary treatment did not affect outcome after salvage therapy.
journal_name
J Adolesc Young Adult Oncoljournal_title
Journal of adolescent and young adult oncologyauthors
Vijayasekharan K,Ramanathan S,Chinnaswamy G,Prasad M,Gulia A,Janu A,Rekhi B,Ramadwar M,Khanna N,Laskar S,Puranadare N,Bajpai J,Puri A,Banavali S,Vora Tdoi
10.1089/jayao.2020.0016subject
Has Abstractpub_date
2020-07-20 00:00:00eissn
2156-5333issn
2156-535Xpub_type
杂志文章abstract::Many adolescent female cancer patients will survive into their reproductive years. Pediatric oncologists are advised to discuss oncofertility during treatment planning. In this pilot study, 19 adolescent females completed a retrospective survey assessing recall of a fertility discussion, satisfaction with fertility kn...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2017.0079
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:Young adult oncology has gained momentum in recognizing the unique medical and psychosocial needs of the population of adolescents and young adults with cancer (AYAC). However, many of their psychosocial needs remain unmet and we are yet to identify how clinical or research programs can be tailored to meet thes...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章,随机对照试验
doi:10.1089/jayao.2017.0101
更新日期:2019-04-01 00:00:00
abstract:: Purpose: Cancer-related fatigue is a burdensome late effect of cancer treatment. A pilot study showed the effectiveness of cognitive-behavioral therapy (CBT) in fatigued survivors of childhood cancer (CCS). The aim of this study is to investigate whether the six cognitive-...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0094
更新日期:2020-08-27 00:00:00
abstract::Childhood cancer survivors (CCS) are at increased risk of subsequent malignant neoplasms (SMNs). However, the impact of SMNs on long-term psychosocial functioning is unknown. In a cohort of 322 young adult CCS, survivors who developed a SMN (n = 43, 13.4%) did not report a significantly higher burden of fatigue, insom...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0046
更新日期:2020-08-14 00:00:00
abstract:PURPOSE:As a consequence of cancer treatment, many adolescents and young adults (AYA) patients are required to take leave or face setbacks from their education. While most AYA cancer survivors and survivors of childhood cancer are capable of successfully returning to the educational system, unsuccessful returns place A...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2018.0058
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Young adult cancer survivors have a number of increased health and psychosocial risks. To minimize these risks, they must address any modifiable risk factors, for example increase their physical activity (PA) and reduce stress. Unfortunately, more than half of young survivors remain sedentary, and few participa...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章,随机对照试验
doi:10.1089/jayao.2015.0033
更新日期:2016-03-01 00:00:00
abstract::Adolescents and young adults (AYAs) 15-39 years old face unique challenges during cancer treatment as developmental and social needs are often disrupted to achieve cure. Developmentally appropriate supportive care for AYAs across the cancer trajectory is needed. The purpose of this review is to identify and describe i...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章,评审
doi:10.1089/jayao.2017.0127
更新日期:2018-06-01 00:00:00
abstract:: Purpose: Most evidence for the relationship between physical activity, nutrition education, and late effects from cancer treatment come from cross-sectional studies. The purpose of this pilot study was to determine if 8 weeks of exercise and nutrition education in adolesce...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0116
更新日期:2020-09-14 00:00:00
abstract:: Purpose: To explore and highlight the opportunities and challenges that underlie the development of survivorship care for adolescent and young adult cancer. Methods: A multimethod approach was used, with perspectives of survivo...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2019.0031
更新日期:2019-10-01 00:00:00
abstract::The inclusion of asparaginase in chemotherapy regimens to treat acute lymphoblastic leukemia (ALL) has had a positive impact on survival in pediatric patients. Historically, asparaginase has been excluded from most treatment protocols for adolescent and young adult (AYA) patients because of perceived toxicity in this ...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章,评审
doi:10.1089/jayao.2015.0014
更新日期:2015-09-01 00:00:00
abstract:: Purpose: Young adults with cancer often experience stress, depression, and anxiety. Mindfulness meditation is an effective intervention for these outcomes, and maintenance support may be needed for long-term improvements. eHealth technologies provide a promising delivery s...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0102
更新日期:2020-12-21 00:00:00
abstract::Following a presentation with abdominal pain, a 22-year-old female was diagnosed with a massive primary liver immature teratoma with evidence of omental and pelvic metastases. Despite chemotherapy, the teratoma continued to rapidly increase in size. Significant treatment-associated myelosuppression was challenging as ...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2019.0081
更新日期:2020-02-01 00:00:00
abstract:PURPOSE:To examine key factors related to adolescent cancer survivors' return to school after cancer treatment completion, which can be a time of complex transition. PATIENTS AND METHODS:Seventy semi-structured interviews were conducted with 19 adolescent cancer survivors (mean age 16.1 years), 21 mothers, 15 fathers,...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2011.0006
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:Hodgkin lymphoma (HL) is the commonest cancer in adolescents and young adults (AYAs), aged 15-29 years. While the survival rate is high, many survivors experience adverse late effects of therapy. Yet, this age group in general makes limited use of health services. This study sought to determine whether the need...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2015.0039
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:There is a growing interest in fertility preservation as emerging research is highlighting the prevalence of infertility among young cancer survivors and its negative impact on quality of life. Previous qualitative research has identified barriers of fertility preservation care among professionals. The aim of t...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2016.0087
更新日期:2017-09-01 00:00:00
abstract:: Purpose: Testicular germ cell tumors (TGCT) are the most common solid organ malignancy in young men. It is a largely curable disease, so the extent to which it affects quality of life-including male fertility-is important. Abnormal semen analysis is highly predictive of ma...
journal_title:Journal of adolescent and young adult oncology
pub_type: 评审
doi:10.1089/jayao.2014.0012
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Oncologic outcomes in advanced testicular cancer (TC) depend on appropriate and timely care. Often this care is referred to tertiary academic medical centers (AMCs). The aim of this study was to compare oncologic outcomes of adolescent and young adult (AYA) patients with TC treated from the outset at an AMC to ...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2015.0057
更新日期:2016-09-01 00:00:00
abstract:PURPOSE:This study describes the prevalence of religious and/or spiritual (R/S) struggle in long-term young adult (YA) survivors following hematopoietic cell transplantation (HCT) as well as existential concerns (EC), social support, and demographic, medical, and emotional correlates of R/S struggle. METHODS:Data were...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2017.0069
更新日期:2018-04-01 00:00:00
abstract::Based on an increased appreciation of the unique challenges facing adolescents and young adults with cancer, there has been a coordinated national effort in Australia in recent years to address this issue. In 2007, CanTeen, a consumer support organization for young people with cancer, partnered with the Australian fed...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2012.0032
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:Orthotopic liver transplantation (OLT) is curative for hepatocellular carcinoma (HCC). HCC is typically a disease of older adults (OAs); therefore, characteristics and outcomes of OLT for young adults (YAs) (ages 18-40) are not described. The objective of this study was to assess the characteristics and outcome...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2016.0048
更新日期:2017-06-01 00:00:00
abstract:: Purpose: Survivors of cancer diagnosed during adolescence and young adulthood (AYA; aged 15-39) may experience quality of life (QOL) limitations; however, little is known about QOL for AYA survivors who are now middle-aged or among racial/ethnic minority survivors. We eval...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2013.0035
更新日期:2014-06-01 00:00:00
abstract::This paper describes the development of an institution-specific website designed to meet the supportive and emotional needs of young adults (18-39 years old) with cancer in the United States. The website contains information about topics of particular interest to young adults, coping skills education, and resources; a...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2014.0035
更新日期:2015-03-01 00:00:00
abstract:PURPOSE:Cancer-related fatigue in adults has been the subject of considerable recent research, confirming its importance as a common and debilitating symptom, and establishing a number of evidence-based interventions. There has, however, been limited focus on the fatigue suffered by teenagers and young adults with canc...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章,评审
doi:10.1089/jayao.2014.0023
更新日期:2015-03-01 00:00:00
abstract:: Purpose: To evaluate the impact of a series of one-day events delivered by Trekstock, a charity supporting young adults with cancer in the United Kingdom. Methods: Data on physical activity, mood, perceived support, self-effica...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2019.0108
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:As many as two-thirds of male childhood cancer survivors are at risk for fertility impairment as a consequence of treatment. Despite this, survivorship guidelines lack concrete recommendations as to when fertility status conversations should happen between patients and providers and what should be discussed. Th...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2018.0094
更新日期:2019-02-01 00:00:00
abstract:: Purpose: Rates of obesity and obesity-related health consequences, including type 2 diabetes (T2D) and cancer, continue to rise. While cancer patients are at an increased risk of developing T2D, the prevalence of T2D and insulin prescription among young patients with cance...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0071
更新日期:2020-07-29 00:00:00
abstract::Hypogammaglobulinemia is a poorly described complication of chemotherapy in adolescents and young adults (AYAs, 15-39 years) with acute lymphoblastic leukemia (ALL). The majority of AYAs treated on a Berlin-Frankfurt-Munster-based ALL regimen experienced hypogammaglobulinemia (65.0% [13/20]). Febrile neutropenia episo...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0060
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:Adolescents with cancer have unique developmental considerations. These include brain development, particularly in the frontal lobe, and a focus on completing education and entering the workforce. Cancer and treatment at this stage may prove to uniquely affect survivors' experience of cognitive and occupational...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2017.0043
更新日期:2018-02-01 00:00:00
abstract::Adolescents and young adults (AYAs) with cancer represent a unique group with unmet needs. Metrics and quality indicators are important for evaluating AYA cancer care. The purpose of this study is to describe the quality indicators in a Canadian context that are used for AYA (15-39 years of age) cancer care and contro...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2019.0069
更新日期:2020-02-01 00:00:00
abstract:: Purpose: This study describes the prevalence trends of electronic cigarette (e-cigarette) use in young adult cancer survivors and compares these to the prevalence among young adults without a cancer history. It also examines the association between conventional cigarette u...
journal_title:Journal of adolescent and young adult oncology
pub_type: 杂志文章
doi:10.1089/jayao.2020.0104
更新日期:2020-09-30 00:00:00