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Title: Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma

Abstract

Purpose: To report the results of a conservative strategy based on partial surgery combined with brachytherapy in a prospective cohort of children with bladder–prostate rhabdomyosarcoma (BP RMS). Methods and Materials: We prospectively documented the outcome of children treated in our department between 1991 and 2015 for BP RMS and undergoing a multimodal approach combining conservative surgery (partial cystectomy and/or partial prostatectomy) and perioperative interstitial low-dose-rate or pulse-dose-rate brachytherapy. Before brachytherapy, children had received chemotherapy with modalities depending on their risk group of treatment. Results: A total of 100 patients were identified, with a median age of 28 months (range, 5.6 months-14 years). According to the Intergroup Rhabdomyosarcoma Study (IRS) group, 84 were IRS-III, and 12 were IRS-IV tumors. Four patients were treated at relapse. The median number of chemotherapy cycles before local therapy was 6 (range, 4-13). After surgery, 63 patients had a macroscopic tumor residuum. Five patients underwent a brachytherapy boost before pelvic external beam radiation therapy because of nodal involvement, and 95 had exclusive brachytherapy. Median follow-up was 64 months (range, 6 months-24.5 years). Five-year disease-free and overall survival rates were 84% (95% confidence interval 80%-88%) and 91% (95% confidence interval 87%-95%), respectively. At last follow-up most survivors presented with onlymore » mild to moderate genitourinary sequelae and a normal diurnal urinary continence. Five patients required a secondary total cystectomy: 3 for a nonfunctional bladder and 2 for relapse. Conclusion: Brachytherapy is effective as part of a conservative strategy for BP RMS, with a relatively low delayed toxicity as compared with previously published studies using external beam radiation therapy. Longer follow-up is required to ensure that the functional results are maintained over time.« less

Authors:
 [1];  [2];  [2];  [1];  [3];  [4];  [3]; ; ; ;  [1];  [1];  [2];  [4];
  1. Brachytherapy Unit, Department of Radiotherapy, Gustave Roussy, Villejuif (France)
  2. (France)
  3. Department of Pediatric Surgery, Bicêtre Hospital, Hôpitaux Universitaires Paris Sud, Assistance Publique des Hôpitaux de Paris, Le Kremlin-Bicêtre (France)
  4. Department of Pediatric and Adolescent Oncology, Gustave Roussy, Villejuif (France)
Publication Date:
OSTI Identifier:
22649932
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 2; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLADDER; BRACHYTHERAPY; CHEMOTHERAPY; CHILDREN; CONNECTIVE TISSUE; EXTERNAL BEAM RADIATION THERAPY; PATIENTS; RADIATION HAZARDS; RHABDOMYOSARCOMAS; SURGERY

Citation Formats

Chargari, Cyrus, E-mail: cyrus.chargari@gustaveroussy.fr, Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, Haie-Meder, Christine, Guérin, Florent, Minard-Colin, Véronique, Lambert, Guénolée de, Mazeron, Renaud, Escande, Alexandre, Marsolat, Fanny, Dumas, Isabelle, Deutsch, Eric, Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris Saclay, Paris, Valteau-Couanet, Dominique, and and others. Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.02.026.
Chargari, Cyrus, E-mail: cyrus.chargari@gustaveroussy.fr, Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, Haie-Meder, Christine, Guérin, Florent, Minard-Colin, Véronique, Lambert, Guénolée de, Mazeron, Renaud, Escande, Alexandre, Marsolat, Fanny, Dumas, Isabelle, Deutsch, Eric, Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris Saclay, Paris, Valteau-Couanet, Dominique, & and others. Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma. United States. doi:10.1016/J.IJROBP.2017.02.026.
Chargari, Cyrus, E-mail: cyrus.chargari@gustaveroussy.fr, Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, Haie-Meder, Christine, Guérin, Florent, Minard-Colin, Véronique, Lambert, Guénolée de, Mazeron, Renaud, Escande, Alexandre, Marsolat, Fanny, Dumas, Isabelle, Deutsch, Eric, Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris Saclay, Paris, Valteau-Couanet, Dominique, and and others. Thu . "Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma". United States. doi:10.1016/J.IJROBP.2017.02.026.
@article{osti_22649932,
title = {Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma},
author = {Chargari, Cyrus, E-mail: cyrus.chargari@gustaveroussy.fr and Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge and French Military Health Service Academy, Ecole du Val-de-Grâce, Paris and Haie-Meder, Christine and Guérin, Florent and Minard-Colin, Véronique and Lambert, Guénolée de and Mazeron, Renaud and Escande, Alexandre and Marsolat, Fanny and Dumas, Isabelle and Deutsch, Eric and Faculté de Médecine Paris Sud, Université Paris Sud, Université Paris Saclay, Paris and Valteau-Couanet, Dominique and and others},
abstractNote = {Purpose: To report the results of a conservative strategy based on partial surgery combined with brachytherapy in a prospective cohort of children with bladder–prostate rhabdomyosarcoma (BP RMS). Methods and Materials: We prospectively documented the outcome of children treated in our department between 1991 and 2015 for BP RMS and undergoing a multimodal approach combining conservative surgery (partial cystectomy and/or partial prostatectomy) and perioperative interstitial low-dose-rate or pulse-dose-rate brachytherapy. Before brachytherapy, children had received chemotherapy with modalities depending on their risk group of treatment. Results: A total of 100 patients were identified, with a median age of 28 months (range, 5.6 months-14 years). According to the Intergroup Rhabdomyosarcoma Study (IRS) group, 84 were IRS-III, and 12 were IRS-IV tumors. Four patients were treated at relapse. The median number of chemotherapy cycles before local therapy was 6 (range, 4-13). After surgery, 63 patients had a macroscopic tumor residuum. Five patients underwent a brachytherapy boost before pelvic external beam radiation therapy because of nodal involvement, and 95 had exclusive brachytherapy. Median follow-up was 64 months (range, 6 months-24.5 years). Five-year disease-free and overall survival rates were 84% (95% confidence interval 80%-88%) and 91% (95% confidence interval 87%-95%), respectively. At last follow-up most survivors presented with only mild to moderate genitourinary sequelae and a normal diurnal urinary continence. Five patients required a secondary total cystectomy: 3 for a nonfunctional bladder and 2 for relapse. Conclusion: Brachytherapy is effective as part of a conservative strategy for BP RMS, with a relatively low delayed toxicity as compared with previously published studies using external beam radiation therapy. Longer follow-up is required to ensure that the functional results are maintained over time.},
doi = {10.1016/J.IJROBP.2017.02.026},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 98,
place = {United States},
year = {Thu Jun 01 00:00:00 EDT 2017},
month = {Thu Jun 01 00:00:00 EDT 2017}
}