Local Control With Reduced-Dose Radiotherapy for Low-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group D9602 Study
- Department of Radiation Oncology, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, OH (United States)
- Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, NE (United States)
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States)
- Children's Cancer Hospital and Division of Pediatrics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY (United States)
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States)
- Quality Assurance Review Center, Lincoln, RI (United States)
- Department of Surgery, East Carolina University, Greenville, NC (United States)
- Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)
- Division of Hematology/Oncology, Children's Memorial Medical Center, Chicago, IL (United States)
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA (United States)
Purpose: To analyze the effect of reduced-dose radiotherapy on local control in children with low-risk rhabdomyosarcoma (RMS) treated in the Children's Oncology Group D9602 study. Methods and Materials: Patients with low-risk RMS were nonrandomly assigned to receive radiotherapy doses dependent on the completeness of surgical resection of the primary tumor (clinical group) and the presence of involved regional lymph nodes. After resection, most patients with microscopic residual and uninvolved nodes received 36 Gy, those with involved nodes received 41.4 to 50.4 Gy, and those with orbital primary tumors received 45 Gy. All patients received vincristine and dactinomycin, with cyclophosphamide added for patient subsets with a higher risk of relapse in Intergroup Rhabdomyosarcoma Study Group III and IV studies. Results: Three hundred forty-two patients were eligible for analysis; 172 received radiotherapy as part of their treatment. The cumulative incidence of local/regional failure was 15% in patients with microscopic involved margins when cyclophosphamide was not part of the treatment regimen and 0% when cyclophosphamide was included. The cumulative incidence of local/regional failure was 14% in patients with orbital tumors. Protocol-specified omission of radiotherapy in girls with Group IIA vaginal tumors (n = 5) resulted in three failures for this group. Conclusions: In comparison with Intergroup Rhabdomyosarcoma Study Group III and IV results, reduced-dose radiotherapy does not compromise local control for patients with microscopic tumor after surgical resection or with orbital primary tumors when cyclophosphamide is added to the treatment program. Girls with unresected nonbladder genitourinary tumors require radiotherapy for postsurgical residual tumor for optimal local control to be achieved.
- OSTI ID:
- 22056415
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 83, Issue 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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