Long-term results of three-dimensional conformal radiation therapy for patients with rhabdomyosarcoma Journal Article


Authors: Wolden, S. L.; La, T. H.; LaQuaglia, M. P.; Meyers, P. A.; Kraus, D. H.; Wexler, L. H.
Article Title: 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. © 2003 American Cancer Society.
Keywords: adolescent; adult; cancer survival; child; controlled study; human tissue; treatment outcome; child, preschool; survival rate; major clinical study; cancer recurrence; cancer radiotherapy; combined modality therapy; cancer staging; lymph node metastasis; lymphatic metastasis; neoplasm staging; antineoplastic combined chemotherapy protocols; radiotherapy dosage; prediction; histology; dose-response relationship, radiation; survival time; correlation analysis; infant; cancer size; radiation therapy; radiotherapy, conformal; cancer control; rhabdomyosarcoma; dose fractionation; computer assisted radiotherapy; soft tissue neoplasms; three-dimensional; humans; prognosis; human; male; female; priority journal; article; pediatric, local control
Journal Title: Cancer
Volume: 97
Issue: 1
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2003-01-01
Start Page: 179
End Page: 185
Language: English
DOI: 10.1002/cncr.11001
PUBMED: 12491519
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Dennis Kraus
    268 Kraus
  2. Suzanne L Wolden
    560 Wolden
  3. Leonard H Wexler
    191 Wexler
  4. Paul Meyers
    311 Meyers
  5. Trang La
    4 La