Long‐term results of three‐dimensional conformal radiation therapy for patients with rhabdomyosarcoma

Abstract

BACKGROUND The authors evaluated the outcome of patients with rhabdomyosarcoma (RMS) who were treated with three‐dimensional (3D) conformal radiation therapy (RT) at a single institution. METHODS The records of all 69 patients with RMS who received 3D RT from 1989 to 2001 were reviewed. All patients received multiagent chemotherapy with or without surgical resection. Follow‐up of surviving patients ranged from 1.0 year to 12.8 years (median, 4.3 years). RESULTS The median patient age was 6 years (range, 1–29 years), and there was a male:female ratio of 1.5:1. Forty‐eight patients had embryonal sarcomas, 14 patients had alveolar sarcomas, and 7 patients had undifferentiated sarcomas. The parameningeal area (n = 22 patients) and the trunk (n = 21 patients) were the most common sites. Twelve percent of patients had Stage I disease, 10% of patients had Stage II disease, 51% of patients had Stage III disease, and 27% of patients had Stage V disease. Nine percent of patients were in clinical Group II, 64% of patients were in Group III, and 27% of patients were in Group IV. Regional lymph nodes were involved in 33% of patients, and 77% of tumors measured ≥ 5 cm in greatest dimension. The actuarial 5‐year local and regional control rates were 90% and 91%, respectively. No predictive factors for local failure were identified; however, alveolar histology was correlated with regional recurrence (29% compared with 4%; P = 0.02). The disease free and overall survival rates were 60% and 63% at 5 years, respectively. Disease stage was most predictive of 5‐year survival (76% of patients with Stage I–III disease compared with 24% of patients with Stage IV disease; P < 0.001). CONCLUSIONS High rates of local control were achieved in patients with RMS using 3D RT. Regional lymph node failure was increased significantly among patients with alveolar histology. Control of metastatic disease remains a formidable problem for patients with Stage IV RMS. Cancer 2003;97:179–85. © 2002 American Cancer Society. DOI 10.1002/cncr.11001

The prognosis and effects of local treatment strategies for orbital embryonal rhabdomyosarcoma: a population-based study

“…Intensity-modulated RT is superior to conventional RT because of its higher treatment accuracy and better protection of normal organs. 33 In addition, proton therapy may further lower the integral dose and spare normal tissues compared with intensity-modulated RT for orbital embryonal rhabdomyosarcoma. 34 Interstitial brachytherapy is also an effective treatment for children with primary orbital rhabdomyosarcomas.…”

The impact of radiotherapy on clinical outcomes in parameningeal rhabdomyosarcoma

“…The modern RT techniques improve the target dose coverage (i.e., three-dimensional conformal RT [17] or intensity modulated RT [18]). The current risk-based approach [9] and tailored multimodal treatment [19] might also contribute to the improvement in treatment outcome.…”

Rhabdomyosarcoma: New Windows of Opportunity

“…For selected patients, brachytherapy may be considered [81]. Three-dimensional conformal radiotherapy results in excellent local tumor control and is routinely used in many centers [82]. The present intermediate-risk COG trial (D9803) is evaluating selected radiotherapy dose reductions depending on the initial tumor response and resectability.…”