Rhabdomyosarcoma of the Head and Neck: A Multimodal Approach

Casey, Dana L.; Wolden, Suzanne L.

doi:10.1055/s-0037-1617450

Cited by 22 publications

(26 citation statements)

References 40 publications

(32 reference statements)

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“…As such, these patients are treated with definitive chemoradiation, with the goal of maintaining form and function. 3 Local relapse is the dominant form of failure for HN-RMS and results in a high mortality rate as well as devastating physical and functional consequences in the children that survive.…”

Section: Introductionmentioning

confidence: 99%

Worse Outcomes for Head and Neck Rhabdomyosarcoma Secondary to Reduced-Dose Cyclophosphamide

Casey

Wexler

Wolden

2019

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Recent trends including the use of proton therapy and administration of reduced-doses of cyclophosphamide have been adapted in head and neck rhabdomyosarcoma (HN-RMS) to reduce late morbidity. Our primary goal was to analyze local control and survival outcomes after photon versus proton irradiation in pediatric patients with HN-RMS, with the secondary goal of analyzing the effect of cyclophosphamide dose on disease outcomes. Methods and Materials: This single-institution cohort study was comprised of 76 pediatric HN-RMS patients treated with definitive chemoradiation from 2000 to 2018. Fifty-one patients (67%) received intensity-modulated photon radiation therapy (IMRT) and 25 (33%) proton therapy. Results: Local failure (LF) at 2 years was 12.5% for parameningeal RMS and 0% for orbital RMS and other head and neck sites (p=0.24). Patients treated with protons were more likely to have received reduced-dose cyclophosphamide (p<0.0001). The 2-year LF was 7.9% in the IMRT cohort versus 14.6% in the proton cohort (p=0.07), with no difference in survival outcomes. Cumulative cyclophosphamide dose was significantly associated with 2-year LF: 0% for cumulative dose of >20g/m 2 versus 15.3% for ≤20g/m 2 (p=0.04). Among parameningeal RMS patients (n=59), both cumulative cyclophosphamide dose and dose-intensity were associated with local failure (p=0.01). There was a trend toward worse event-free survival for parameningeal RMS patients who received reduced-dose-intensity cyclophosphamide (59.2% versus 70.6%, p=0.11). Conclusions: Both dose-intensity and cumulative cyclophosphamide dose seem to play an important role in achieving local control for HN-RMS patients treated with either protons or photons. Longer follow-up is needed to further assess disease outcomes with proton therapy.

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Section: Introductionmentioning

confidence: 99%

Worse Outcomes for Head and Neck Rhabdomyosarcoma Secondary to Reduced-Dose Cyclophosphamide

Casey

Wexler

Wolden

2019

International Journal of Radiation Oncology*Biology*Physics

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“…For the purpose of this study, the NRSTS group was selected for further analysis. Rhabdomyosarcoma was not included because the clinical behavior and treatment differs from NRSTS 16 . Rhabdoid tumor was not included because this lesion is sufficiently unique to be best studied independently 17 .…”

Section: Methodsmentioning

confidence: 99%

“…Rhabdomyosarcoma was not included because the clinical behavior and treatment differs from NRSTS. 16 Rhabdoid tumor was not included because this lesion is sufficiently unique to be best studied independently. 17 Osteosarcomas, chondrosarcomas, and odontogenic sarcomas were not included because the study focuses on sarcomas of soft tissue origin.…”

Section: Case Selectionmentioning

confidence: 99%

Survival of Patients With Non‐Rhabdomyosarcoma Soft Tissue Sarcomas of the Head and Neck

et al. 2020

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Objective To evaluate factors associated with overall survival (OS) of patients with non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck. Study Design Retrospective cohort study. Methods The National Cancer Database was queried for cases of non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck between 2004 and 2014. Cases were categorized according to the World Health Organization classification of soft tissue tumors. A multivariable Cox proportional hazards model was used to evaluate associations with OS. Results A total of 4,555 patients (63.6% male, 36.4% female, mean age 59.6 years) met inclusion criteria. The majority of tumors were classified as miscellaneous (35.9%), followed by vascular (20.1%), smooth muscle (13.5%), fibroblastic/myofibroblastic (12.1%), peripheral nerve (8.5%), adipocytic (7.4%), and undifferentiated (2.5%) sarcomas. The mean follow‐up was 37.9 months, and overall mortality (MR) was 45.3%. The best prognosis was seen with fibroblastic/myofibroblastic sarcomas (MR = 20.6%, P < .001), whereas vascular sarcomas had the worst prognosis (MR = 67.6%, P < .001). Resection with clear margins had better OS than microscopically positive margins (hazard ratio [HR] = 1.43, P < .001) or grossly positive margins (HR = 2.97, P < .001). Radiation therapy was associated with better OS than no radiation (HR = 0.86, P = .001). Conclusion Non‐rhabdomyosarcoma soft tissue sarcomas of the head and neck are associated with significant mortality. OS differs based on histologic subcategorization. Resection of the primary tumor with clear margins demonstrates improved OS for all histologies, suggesting this modality remains the preferred primary treatment when feasible. Level of Evidence 3 Laryngoscope, 131:E500–E508, 2021

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“…Its malignant degree is high, its growth is rapid, and it shows infiltration growth and early metastasis. 14 In this study, 13 cases had tumors in head and neck and 11 had tumors in the trunk, accounting for 80.6%, which were the high-incidence sites. Among them, 25 cases were embryonic type, accounting for 83.3%, which was the main pathological type, and it was consistent with the results reported in previous study.…”

Section: Discussionmentioning

confidence: 61%

Evaluation of clinical efficacy of Chemotherapy for Rhabdomyosarcoma in children

Ning¹,

Liu²,

Wei³

et al. 2020

Pak J Med Sci

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Objective: To investigate the clinical characteristics and treatment methods of rhabdomyosarcoma in children and the efficacy of the methods. Methods: The clinical data of 30 children with rhabdomyosarcoma who were admitted to our hospital from August 2013 to August 2017 were retrospectively analyzed. The clinical characteristics were summarized, and the curative effect and prognosis were evaluated. Results: Among all the children (N=30), there were 20 males and 10 females, with a median age of 3.5 years. As to the primary site, there were 13 cases of head and neck, 11 cases of trunk, three cases of urogenital system and three cases of limbs. There were 25 cases of embryonic type, 4 cases of alveolar type and one case of polymorphic type. As to the clinical stage, there were one case of stage I, 9 cases of stage II, 13 cases of stage III and 7 cases of stage IV. There were one case of low risk, 19 cases of medium risk and 10 cases of high risk. Eight cases received surgery alone, 22 cases received combined treatment of surgery and chemotherapy (the chemotherapeutics followed three schemes, low-risk group (VAC+VA), moderate risk group (VAC) and high risk group (alternating use of VDC and IE). Among all the cases (N=30), there were 14 cases of complete remission (CR), five cases of partial remission (PR), four cases of stable disease (SD), and 7 cases of progressive disease (PD). The CR rate was (N=14, 46.7%). The three-year overall survival (OS) rate was (N=19, 63.3%). The clinical efficacy and prognosis of children receiving surgery and chemotherapy were better than those of children receiving surgery alone, and the difference was statistically significant (P<0.05). Conclusion: Rhabdomyosarcoma in children frequently happens in the head, neck and trunk. Embryonic type is the main pathological type of rhabdomyosarcoma. Comprehensive and standardized treatment based on surgery and chemotherapy is an important way to improve the curative effect in the treatment of rhabdomyosarcoma in children. doi: https://doi.org/10.12669/pjms.36.5.1829 How to cite this:Ning Z, Liu X, Qin G, Wei L, Li X, Shen J. Evaluation of clinical efficacy of Chemotherapy for Rhabdomyosarcoma in children. Pak J Med Sci. 2020;36(5):1069-1074. doi: https://doi.org/10.12669/pjms.36.5.1829 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rhabdomyosarcoma of the Head and Neck: A Multimodal Approach

Cited by 22 publications

References 40 publications

Worse Outcomes for Head and Neck Rhabdomyosarcoma Secondary to Reduced-Dose Cyclophosphamide

Worse Outcomes for Head and Neck Rhabdomyosarcoma Secondary to Reduced-Dose Cyclophosphamide

Survival of Patients With Non‐Rhabdomyosarcoma Soft Tissue Sarcomas of the Head and Neck

Evaluation of clinical efficacy of Chemotherapy for Rhabdomyosarcoma in children

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