Four Ways to Decrease Late Toxicity From Pelvic Radiation Therapy in Children and Young Adults

Blitzer, Grace C.; Bradley, Kristin

doi:10.1016/j.prro.2021.07.001

Cited by 2 publications

(2 citation statements)

References 27 publications

(39 reference statements)

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“…Approximately 75% of children with RMS are treated with RT, and long-term side effects have frequently been observed at different sites (4). When pelvic radiation is used for pediatric RMS, RT-related toxicity can affect normal tissues, which may result in growth asymmetries, cystitis, infertility, and sexual dysfunction (24)(25)(26). Late radiation-induced toxicity also includes decreased bone growth, increased risk of secondary malignancy, and hematuria (27)(28)(29).…”

Section: A B D Cmentioning

confidence: 99%

“…Late radiation-induced toxicity also includes decreased bone growth, increased risk of secondary malignancy, and hematuria (27)(28)(29). Therefore, we must be aware of the potential toxicity to patients' lives (25). Currently, at least three randomized clinical trials of pediatric RMS to evaluate the survival impact of RT are i n p r o g r e s s ( N C T 0 0 0 0 2 9 9 5 , N C T 0 1 6 2 6 1 7 0 , a n d NCT00075582).…”

Section: A B D Cmentioning

confidence: 99%

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Prognostic factors of pediatric pelvic and genitourinary rhabdomyosarcoma: An analysis based on SEER database

Shou

Cai

et al. 2022

Front. Oncol.

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BackgroundRhabdomyosarcoma (RMS) is the most common soft-tissue sarcomas in children. This study aimed to investigate the prognostic factors of pelvic and genitourinary RMS in children and evaluate the survival outcomes of these children treated with or without radiation therapy (RT).MethodsThe Surveillance, Epidemiology, and End Results Program (SEER) database was required for children with pelvic and genitourinary RMS. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses.ResultsFor the 262 patients analyzed, the most common biological subtypes were embryonic (n=209, 79.8%) and alveolar (n=29, 11.1%). Patients with alveolar RMS had the worst prognosis (P < 0.05). The testis (n=122, 46.6%) was the most common location, followed by the urinary bladder (n=57, 21.8%) and prostate (n=48, 18.3%). Uterus RMS had the highest survival rate, followed by testis, urinary bladder, and prostate RMS. Favorable prognostic factors were age at diagnosis < 15 years, non-alveolar histological subtype, early tumor stage (localized/regional), specific sites (uterus and testis), and treatment (cancer-directed surgery and chemotherapy) (P < 0.05). Propensity score-matched analyses comparing the cohorts of patients treated with or without RT demonstrated no significant differences in prognostic survival (OS: P=0.872, CSS: P=0.713).ConclusionThe nomogram constructed based on independent prognostic factors may accurately predict survival rates at 1 and 5 years. Surgery and adjuvant chemotherapy can be effective treatments, but RT fails to guarantee a survival benefit. Therefore, prospective trials evaluating RT for pediatric pelvic and genitourinary RMS are warranted.

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