Y. Wang1, S. Li1, M. Jiang2, Y. Xie1, X. Li1, L. Huang1, X. Lin3, L. Yang4, and M. Lu5; 1Department of Radiation Oncology,Chongqing University Cancer Hospital, Chongqing, China, 2Department of Oncology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China., shanghai, China, 3Department of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, China, 4Department of Radiation Oncology,Chongqing University Cancer Hospital, Chongqing, Chongqing, China, 5Oncology Radiotherapy Center of Chongqing University Cancer Hospital, chongqing, China
Purpose/Objective(s): Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcomas during childhood. The first line treatment for these children consists of chemotherapy, surgical resection, and radiotherapy. Although the Chinese and American Children Oncology collaborative groups have given standard treatment guidelines, there are still differences in prognosis. Our aim is to explore the best treatment mode and prognosis of RMS in China. Investigate the prognostic factors of RMS in these children treated with radiation therapy. Materials/
Methods: All newly diagnosed patients with RMS who received RT at 2 institution in China between 2011 and 2022 were retrospectively analyzed. OS were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models. Results: In total, 280 patients (166 male; 114 female) were included in the analysis. Embryonic RMS (n=196, 70.0%) were most common, followed by alveolar RMS (n=57, 20.3%). The median age at diagnosis was 47.5 months (range, 3-185 months). The primary sites included orbit and biliary tract (n=11, 3.9%), abdominal and pelvic cavity (n=97, 34.6%), head and neck (n=88, 31.4%), limbs (n=55, 19.6%), perineum (n=17, 6.0%), and thoracic-spine (n=12, 4.2%). Median follow-up of surviving patients was 55.0 months. The median survival was not reached. The 5-year OS rate of all patients receiving radiotherapy was 87.0 ± 2.3%. The 5-year OS rates were 96.6 ± 3.4% for low-risk Group patients, 88.8% ± 3.3% for intermediate-risk Group patients, 78.7% ± 6.7% for high-risk Group patients, and 86.7% ± 5.2% for patients with central nervous system invasion. Log-rank test comparing the patients receiving radiotherapy treated with or without surgery demonstrated no significant differences in OS (P=0.796). In multivariate Cox regression analysis, patients treated with surgery after chemotherapy had worse OS than those treated with surgery before chemotherapy (HR=3.276; 95% CI: 1.270–8.449, P =0.014). Conclusion: In patients who have undergone radiation therapy, surgery may sometimes not necessary. Early surgery may be associated with a better prognosis.
