Complete second look operation and radiotherapy in locally advanced non-alveolar rhabdomyosarcoma in children: A report from the AIEOP soft tissue sarcoma committee.

Abstract

BACKGROUND:

To evaluate the effect of radiotherapy (RT) in association with complete second look operation, histologically confirmed, on outcome of patients with IRS Gr.III non-alveolar RMS.

PROCEDURE:

We analyzed data from 39 patients (age: 0.5-194 months, median 52) who were enrolled between 1988 and 2005 in 2 consecutive Italian Studies, RMS 88 and RMS 96. All achieved a complete resection of the residual tumor after neoadjuvant chemotherapy; 27 did not receive any other local treatment: pelvic 8, extremities 6, head-neck-non-parameningeal 5, orbit 1, genito-urinary-bladder-prostate 3, trunk 2, abdomen 1, vagina 1; 12 were given RT (32-45 Gy), 5 before and 7 after the operation: genito-urinary-bladder-prostate 3, pelvic 3, abdominal 1, extremities 1, head-neck-parameningeal 1, head-neck-non-parameningeal 1, vagina 1, orbit 1. All received postoperative chemotherapy.

RESULTS:

Median follow-up was 81 months (range 17-219 months). With RT: 10/12 patients are in first complete remission; 2/12 had a metastatic relapse (1 also local relapse), and both of them died of disease. Without RT: 16/27 maintained the first complete remission, however 1/16 died due to a second tumor; 8 suffered from local relapse (4 pelvic, 1 orbit, 1 vagina, 1 head-neck-non-parameningeal, 1 abdomen) and 3 of them died, 3 showed a metastatic recurrence (2 extremities, 1 pelvic) and 1 died.

CONCLUSIONS:

Local relapses were more frequent for patients without RT, especially in pelvic sites. The two relapses after RT occurred in huge bladder-prostate RMS. Although the limited number of patients does not allow statistically significant conclusions, our experience suggests that RT may have a positive influence on local control for completely resected non-alveolar RMS.

• Authors: Giovanni Cecchetto, Elena Carretto, Gianni Bisogno, Patrizia Dall'Igna, Andrea Ferrari, Giovanni Scarzello, Alberto Donfrancesco, Rita Alaggio, Paolo Indolfi, Modesto Carli
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 51 Issue 5 Pg. 593-7 (Nov 2008) ISSN: 1545-5017 [Electronic] United States
• PMID: 18668515 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2008 Wiley-Liss, Inc.

Topics

• Adolescent
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Child
• Child, Preschool
• Clinical Trials as Topic
• Combined Modality Therapy
• Female
• Humans
• Infant
• Kaplan-Meier Estimate
• Male
• Neoplasm Recurrence, Local (pathology, therapy)
• Radiotherapy, Adjuvant
• Rhabdomyosarcoma (drug therapy, radiotherapy, surgery)
• Sarcoma
• Second-Look Surgery