{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:05:57Z","timestamp":1780718757272,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T00:00:00Z","timestamp":1487289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U10CA180886"],"award-info":[{"award-number":["U10CA180886"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U10CA180899"],"award-info":[{"award-number":["U10CA180899"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U10CA098543"],"award-info":[{"award-number":["U10CA098543"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U10CA098413"],"award-info":[{"award-number":["U10CA098413"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,6,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Failure\u2010free survival (FFS) and overall survival (OS) rates were found to improve on Intergroup Rhabdomyosarcoma Study (IRS) IV (IRS\u2010IV) compared with IRS\u2010III for patients with subset 2 (IRS stage 1, group III nonorbit or stage 3, group I\/II) low\u2010risk embryonal rhabdomyosarcoma with the addition of cyclophosphamide (total cumulative cyclophosphamide dose of 26.4\u2009g\/m<jats:sup>2<\/jats:sup>) to the combination of vincristine and dactinomycin (VAC). The goal of Children's Oncology Group ARST0331 for subset 2 low\u2010risk patients was to reduce the total cumulative cyclophosphamide dose without compromising FFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Therapy included 4 cycles of VAC (total cumulative cyclophosphamide dose of 4.8\u2009g\/m<jats:sup>2<\/jats:sup>) followed by 12 cycles of vincristine and dactinomycin over 46 weeks. Patients with group II or III tumors received radiotherapy, except for girls with group III vaginal tumors who enrolled before September 2009 and achieved a complete response with chemotherapy with or without delayed surgical resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 66 eligible patients who were followed for a median of 3.5 years, there were 20 failures versus 10.53 expected failures. The estimated 3\u2010year FFS and OS rates were 70% (95% confidence interval [95% CI], 57%\u201080%) and 92% (95% CI, 83%\u201097%), respectively. The estimated 3\u2010year FFS rate was 57% (95% CI, 33%\u201075%) for girls with subset 2 genital tract embryonal rhabdomyosarcoma (21 patients) and 77% (95% CI, 61%\u201087%) for all other subset 2 patients (45 patients) (<jats:italic>P<\/jats:italic>\u2009=\u2009.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The authors observed suboptimal FFS among patients with subset 2 low\u2010risk rhabdomyosarcoma using reduced total cyclophosphamide. Eliminating radiotherapy for girls with group III vaginal tumors in combination with reduced total cyclophosphamide appeared to contribute to the suboptimal outcome. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:2368\u20132375.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30613","type":"journal-article","created":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T10:02:49Z","timestamp":1487325769000},"page":"2368-2375","source":"Crossref","is-referenced-by-count":75,"title":["Reduction of cyclophosphamide dose for patients with subset 2 low\u2010risk rhabdomyosarcoma is associated with an increased risk of recurrence: A report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group"],"prefix":"10.1002","volume":"123","author":[{"given":"David O.","family":"Walterhouse","sequence":"first","affiliation":[{"name":"Division of Hematology Oncology and Stem Cell Transplantation, Ann &amp; Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto S.","family":"Pappo","sequence":"additional","affiliation":[{"name":"Division of Oncology, St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane L.","family":"Meza","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Nebraska Medical Center College of Public Health Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Breneman","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Cincinnati Children's Hospital Medical Center Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hayes\u2010Jordan","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Parham","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Cripe","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology\/Blood and Marrow Transplantation, Nationwide Children's Hospital Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Oncology Clinical Research, Merck Research Laboratories North Wales Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Jimmy Everest Section of Pediatric Hematology and Oncology University of Oklahoma School of Medicine Oklahoma City Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington Seattle 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