PURPOSE: To evaluate local control and toxicity for very young children treated with multimodality therapy for rhabdomyosarcoma (RMS). METHODS AND MATERIALS: From 1990 to 2004, 20 patients<or=36 months at diagnosis were treated at our institution. Nineteen underwent chemotherapy (CMT), surgery and/or intraoperative high-dose-rate brachytherapy (IOHDR), and external-beam radiation (EBRT). Median age was 17 months. Sites included extremity (7), trunk (5), parameningeal (4), orbit (1), head/neck (1), bladder/prostate (1). Histologies consisted of 10 embryonal (53%) and 9 alveolar/undifferentiated (47%). Ten had delayed gross total resection (GTR) at median time of 17 weeks after the start of CMT, and 8 of these underwent IOHDR. Median interval between start of CMT and EBRT was 18 weeks. Median EBRT dose was 36 Gy. EBRT technique was either intensity-modulated (11), three-dimensional (3), or two-dimensional (5). Functional outcome was assessed for patients alive>or=1 year after diagnosis (15) in terms of mild, moderate, or severe deficits. RESULTS: Median follow-up was 33 months for survivors and 23 months for all patients. Two-year actuarial local control, event-free survival, disease-specific survival, and overall survival were 84%, 52%, 74%, and 62%, respectively. All patients who began EBRT<or=18 weeks after the start of CMT had their disease controlled locally. Five have mild deficits and 10 have no deficits. CONCLUSIONS: A reduced dose of 36-Gy EBRT after delayed GTR may maximize local control while minimizing long-term sequelae for very young children with RMS, but unresectable tumors (e.g., parameningeal) require higher doses. Normal-tissue-sparing techniques such as intensity-modulated radiation therapy and IOHDR are encouraged. Local control may be maximized when EBRT begins <or=18 weeks after initiation of CMT, but further study is warranted. Longer follow-up is required to determine the full extent of late effects.
PURPOSE: To evaluate local control and toxicity for very young children treated with multimodality therapy for rhabdomyosarcoma (RMS). METHODS AND MATERIALS: From 1990 to 2004, 20 patients<or=36 months at diagnosis were treated at our institution. Nineteen underwent chemotherapy (CMT), surgery and/or intraoperative high-dose-rate brachytherapy (IOHDR), and external-beam radiation (EBRT). Median age was 17 months. Sites included extremity (7), trunk (5), parameningeal (4), orbit (1), head/neck (1), bladder/prostate (1). Histologies consisted of 10 embryonal (53%) and 9 alveolar/undifferentiated (47%). Ten had delayed gross total resection (GTR) at median time of 17 weeks after the start of CMT, and 8 of these underwent IOHDR. Median interval between start of CMT and EBRT was 18 weeks. Median EBRT dose was 36 Gy. EBRT technique was either intensity-modulated (11), three-dimensional (3), or two-dimensional (5). Functional outcome was assessed for patients alive>or=1 year after diagnosis (15) in terms of mild, moderate, or severe deficits. RESULTS: Median follow-up was 33 months for survivors and 23 months for all patients. Two-year actuarial local control, event-free survival, disease-specific survival, and overall survival were 84%, 52%, 74%, and 62%, respectively. All patients who began EBRT<or=18 weeks after the start of CMT had their disease controlled locally. Five have mild deficits and 10 have no deficits. CONCLUSIONS: A reduced dose of 36-Gy EBRT after delayed GTR may maximize local control while minimizing long-term sequelae for very young children with RMS, but unresectable tumors (e.g., parameningeal) require higher doses. Normal-tissue-sparing techniques such as intensity-modulated radiation therapy and IOHDR are encouraged. Local control may be maximized when EBRT begins <or=18 weeks after initiation of CMT, but further study is warranted. Longer follow-up is required to determine the full extent of late effects.
Authors: Suman Malempati; David A Rodeberg; Sarah S Donaldson; Elizabeth R Lyden; James R Anderson; Douglas S Hawkins; Carola A S Arndt Journal: Cancer Date: 2011-01-24 Impact factor: 6.860
Authors: Brian De; Michael D Kinnaman; Leonard H Wexler; Kim Kramer; Suzanne L Wolden Journal: Pediatr Blood Cancer Date: 2017-07-11 Impact factor: 3.167
Authors: John Breneman; Jane Meza; Sarah S Donaldson; R Beverly Raney; Suzanne Wolden; Jeff Michalski; Fran Laurie; David A Rodeberg; William Meyer; David Walterhouse; Douglas S Hawkins Journal: Int J Radiat Oncol Biol Phys Date: 2011-11-19 Impact factor: 7.038
Authors: Jamie M Aye; Yueh-Yun Chi; Jing Tian; Erin R Rudzinski; Odion T Binitie; Roshni Dasgupta; Suzanne L Wolden; Douglas S Hawkins; Abha A Gupta Journal: Pediatr Blood Cancer Date: 2020-03-02 Impact factor: 3.167
Authors: Renée L Mulder; Dorine Bresters; Malon Van den Hof; Bart Gp Koot; Sharon M Castellino; Yoon Kong K Loke; Piet N Post; Aleida Postma; László P Szőnyi; Gill A Levitt; Edit Bardi; Roderick Skinner; Elvira C van Dalen Journal: Cochrane Database Syst Rev Date: 2019-04-15
Authors: David A Rodeberg; Moody D Wharam; Elizabeth R Lyden; Julie A Stoner; Kenneth Brown; Suzanne L Wolden; Charles N Paidas; Sarah S Donaldson; Douglas S Hawkins; Sheri L Spunt; Carola A Arndt Journal: Int J Cancer Date: 2014-12-10 Impact factor: 7.396
Authors: Rainer Joachim Strege; György Kovács; Jens Eduard Meyer; Detlef Holland; Alexander Claviez; Maximilian H Mehdorn Journal: Strahlenther Onkol Date: 2009-12 Impact factor: 3.621
Authors: Francesco Inchingolo; Marco Tatullo; Andrea Pacifici; Marco Gargari; Alessio D Inchingolo; Angelo M Inchingolo; Gianna Dipalma; Massimo Marrelli; Fabio M Abenavoli; Luciano Pacifici Journal: Head Face Med Date: 2012-12-05 Impact factor: 2.151