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Local control of embryonal rhabdomyosarcoma in children by radiation therapy when combined with chemotherapy
Analysis of this subset of patients in the Intergroup Rhabdomyosarcoma Study indicates that lowering the dose of RT in patients who are receiving concomitant CT is effective in controlling local disease. Although most patients received RT of volumes including the local tumor and immediate regional nodal involvement, the volumes did not subtend the regional nodes in all patients. Our analysis would indicate that withholding RT in patients known to have positive regional nodal involvement and who are receiving concomitant CT may be satisfactory on occasion. At the very least, doses of RT can be modified in such patients, and need not exceed normal tissue tolerance.
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LOCAL CONTROL OF EMBRYONAL RHABDOMYOSARCOMA IN CHILDREN BY RADIATION THERAPY WHEN COMBINED WITH CHEMOTHERAPY Berta Jereb, M.D., Department of Radiation Therapy F. Ghavimi, M.D., Department of Pediatrics P. Exelby, M.D., Department of Surgery/Pediatric Service E. Zang, Clinical Information Center Memorial Sloan-Kettering Cancer Center New York, New York
Between August 1970 and December 1977, 61 patients with embryonal rhabdomyosarcoma (ERMS) were treated at the Radiation Therapy and Pediatric Departments of'Memoria1 Sloan-Kettering Cancer Center. Chemotherapy was given according to T2 protocol or the more aggressive T6 protocol introduced in April 1975. In 45 patients the primary tumor or regional metastases were partially or completely removed, while in 16 the only surgical procedure was biopsy. There were 43 boys and 18 girls, between 4 and 19 years old. Eleven had Stage I-B, 16 had Stage II, 24 had Stage III, and 10 patients had Stage IV tumors. Thirty eight patients (15 with non bulky, 23 with bulky tumors) received T6 protocol. Seventeen patients received more than 4000 rads. Out of the 61 patients, 44 are alive and of these, 40 are disease free. Local tumor control was not achieved in 13 patients, 12 of whom had bulky tumors and 1 was a geographic miss. There were 7 failures in 23 patients treated with more than 4000 rads and 6 failures in 23 patients treated with lower doses. Out of the 13 failures, 5 patients were Stage IV with multiple bulky tumors and 4 patients received less than 3000 rads. It appears from this series that doses between 3000 and 4000 rads given - 4 to 5 weeks together with chemotherapy are adequate for local tumor control in ERMS in children.
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(28)
LOCAL CONTROL OF EMBRYONAL RHABDOMYOSARCOMA IN CHILDREN BY RADIATION THERAPY WHEN COMBINED WITH CHEMOTHERAPY Berta Jereb, M.D., Department of Radiation Therapy F. Ghavimi, M.D., Department of Pediatrics P. Exelby, M.D., Department of Surgery/Pediatric Service E. Zang, Clinical Information Center Memorial Sloan-Kettering Cancer Center New York, New York
Between August 1970 and December 1977, 61 patients with embryonal rhabdomyosarcoma (ERMS) were treated at the Radiation Therapy and Pediatric Departments of'Memoria1 Sloan-Kettering Cancer Center. Chemotherapy was given according to T2 protocol or the more aggressive T6 protocol introduced in April 1975. In 45 patients the primary tumor or regional metastases were partially or completely removed, while in 16 the only surgical procedure was biopsy. There were 43 boys and 18 girls, between 4 and 19 years old. Eleven had Stage I-B, 16 had Stage II, 24 had Stage III, and 10 patients had Stage IV tumors. Thirty eight patients (15 with non bulky, 23 with bulky tumors) received T6 protocol. Seventeen patients received more than 4000 rads. Out of the 61 patients, 44 are alive and of these, 40 are disease free. Local tumor control was not achieved in 13 patients, 12 of whom had bulky tumors and 1 was a geographic miss. There were 7 failures in 23 patients treated with more than 4000 rads and 6 failures in 23 patients treated with lower doses. Out of the 13 failures, 5 patients were Stage IV with multiple bulky tumors and 4 patients received less than 3000 rads. It appears from this series that doses between 3000 and 4000 rads given - 4 to 5 weeks together with chemotherapy are adequate for local tumor control in ERMS in children.
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