SOFT-TISSUE SARCOMA OF THE HEAD AND NECK IN CHILDREN AND ADOLESCENTS

BACKGROUND. The experience of one institution in treating soft tissue sarcomas of the head and neck in a pediatric population is presented. METHODS. Case materials of 134 patients younger than 20 years who were referred to the University of Texas M. D. Anderson Cancer Center betw een 1970 and 1989 for treatment of sarcoma of the head and neck were r etrospectively reviewed. Patients with rhabdomyosarcoma underwent mult imodality treatment consisting of surgery, irradiation, and chemothera py. Wide resection was the treatment used for patients with nonrhabdom yosarcomatous soft tissue sarcomas (NRSTS). Adjuvant chemotherapy and irradiation were used to treat high grade neoplasms and residual disea se. The clinical response to therapy was measured in terms of the dise ase-specific survival rate. RESULTS. Seventy-nine of 134 patients pres ented with untreated or biopsy-proven disease. Fifty-six had rhabdomyo sarcoma and 23 had NRSTS. At 2 and 5 years, the disease-specific survi val rates for patients with rhabdomyosarcoma were 74% and 63%, respect ively, and patients with NRSTS had 80% and 75% disease-specific surviv al rates at 2 and 5 years, respectively. CONCLUSIONS. Rhabdomyosarcoma of the head and neck in children is effectively treated with multimod ality therapy. Prognostic indicators for rhabdomyosarcoma include comp leteness of tumor resection and the development of recurrent disease. Aggressive surgical resection is the treatment of choice for patients with NRSTS. Prognostic indicators for NRSTS include completeness of tu mor resection and the development of recurrent disease. (C) 1996 Ameri can Cancer Society.