Ryoko Suzuki1,2, Hiroko Fukushima1,2, Hajime Okuwaki2, Masako Inaba2, Sho Hosaka2, Yuni Yamaki2, Takashi Fukushima3, Kouji Masumoto4, Masashi Mizumoto5, Hideyuki Sakurai5, Hidetoshi Takada1,2. 1. Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 2. Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan. 3. Pediatric Hematology and Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Tsukuba, Japan. 4. Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 5. Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Abstract
BACKGROUND: The optimal treatment for rhabdomyosarcoma (RMS) requires multidisciplinary treatment with chemotherapy, surgery, and radiotherapy. Surgery and radiotherapy are integral to the local control (LC) of RMS. However, postsurgical and radiotherapy-related complications could develop according to the local therapy and tumor location. In this study, we conducted a single-center analysis of the outcomes and toxicity of multidisciplinary treatment using proton beam therapy (PBT) for pediatric RMS. MATERIALS AND METHODS: RMS patients aged younger than 20 years whose RMS was newly diagnosed and who underwent PBT at University of Tsukuba Hospital (UTH) during the period from 2009 to 2019 were enrolled in this study. The patients' clinical information was collected by retrospective medical record review. RESULTS: Forty-eight patients were included. The 3-year progression-free survival (PFS) and overall survival (OS) rates of all the patients were 68.8% and 94.2%, respectively. The 3-year PFS rates achieved with radical resection, conservative resection, and biopsy only were 65.3%, 83.3%, and 67.6%, respectively (p = 0.721). The 3-year LC rates achieved with radical resection, conservative resection, and biopsy only were 90.9%, 83.3%, and 72.9%, respectively (p = 0.548). Grade 3 or higher mucositis/dermatitis occurred in 14 patients. Although the days of opioid use due to mucositis/dermatitis during the chemotherapy with PBT were longer than those during the chemotherapy without PBT [6.1 and 1.6 (mean), respectively, p = 0.001], the frequencies of fever and elevation of C-reactive protein were equivalent. CONCLUSIONS: Multidisciplinary therapy containing PBT was feasible and provided a relatively fair 3-year PFS, even in children with newly diagnosed RMS without severe toxicity.
BACKGROUND: The optimal treatment for rhabdomyosarcoma (RMS) requires multidisciplinary treatment with chemotherapy, surgery, and radiotherapy. Surgery and radiotherapy are integral to the local control (LC) of RMS. However, postsurgical and radiotherapy-related complications could develop according to the local therapy and tumor location. In this study, we conducted a single-center analysis of the outcomes and toxicity of multidisciplinary treatment using proton beam therapy (PBT) for pediatric RMS. MATERIALS AND METHODS: RMS patients aged younger than 20 years whose RMS was newly diagnosed and who underwent PBT at University of Tsukuba Hospital (UTH) during the period from 2009 to 2019 were enrolled in this study. The patients' clinical information was collected by retrospective medical record review. RESULTS: Forty-eight patients were included. The 3-year progression-free survival (PFS) and overall survival (OS) rates of all the patients were 68.8% and 94.2%, respectively. The 3-year PFS rates achieved with radical resection, conservative resection, and biopsy only were 65.3%, 83.3%, and 67.6%, respectively (p = 0.721). The 3-year LC rates achieved with radical resection, conservative resection, and biopsy only were 90.9%, 83.3%, and 72.9%, respectively (p = 0.548). Grade 3 or higher mucositis/dermatitis occurred in 14 patients. Although the days of opioid use due to mucositis/dermatitis during the chemotherapy with PBT were longer than those during the chemotherapy without PBT [6.1 and 1.6 (mean), respectively, p = 0.001], the frequencies of fever and elevation of C-reactive protein were equivalent. CONCLUSIONS: Multidisciplinary therapy containing PBT was feasible and provided a relatively fair 3-year PFS, even in children with newly diagnosed RMS without severe toxicity.
Authors: Zhaoming Wang; Carmen L Wilson; John Easton; Andrew Thrasher; Heather Mulder; Qi Liu; Dale J Hedges; Shuoguo Wang; Michael C Rusch; Michael N Edmonson; Shawn Levy; Jennifer Q Lanctot; Eric Caron; Kyla Shelton; Kelsey Currie; Matthew Lear; Aman Patel; Celeste Rosencrance; Ying Shao; Bhavin Vadodaria; Donald Yergeau; Yadav Sapkota; Russell J Brooke; Wonjong Moon; Evadnie Rampersaud; Xiaotu Ma; Ti-Cheng Chang; Stephen V Rice; Cynthia Pepper; Xin Zhou; Xiang Chen; Wenan Chen; Angela Jones; Braden Boone; Matthew J Ehrhardt; Matthew J Krasin; Rebecca M Howell; Nicholas S Phillips; Courtney Lewis; Deokumar Srivastava; Ching-Hon Pui; Chimene A Kesserwan; Gang Wu; Kim E Nichols; James R Downing; Melissa M Hudson; Yutaka Yasui; Leslie L Robison; Jinghui Zhang Journal: J Clin Oncol Date: 2018-05-30 Impact factor: 44.544
Authors: Matthew M Ladra; Jackie D Szymonifka; Anita Mahajan; Alison M Friedmann; Beow Yong Yeap; Claire P Goebel; Shannon M MacDonald; David R Grosshans; Carlos Rodriguez-Galindo; Karen J Marcus; Nancy J Tarbell; Torunn I Yock Journal: J Clin Oncol Date: 2014-10-20 Impact factor: 44.544
Authors: H M Maurer; M Beltangady; E A Gehan; W Crist; D Hammond; D M Hays; R Heyn; W Lawrence; W Newton; J Ortega Journal: Cancer Date: 1988-01-15 Impact factor: 6.860
Authors: Debra L Friedman; John Whitton; Wendy Leisenring; Ann C Mertens; Sue Hammond; Marilyn Stovall; Sarah S Donaldson; Anna T Meadows; Leslie L Robison; Joseph P Neglia Journal: J Natl Cancer Inst Date: 2010-07-15 Impact factor: 11.816