Ll. Hughes et al., PARATESTICULAR RHABDOMYOSARCOMA - DELAYED-EFFECTS OF MULTIMODALITY THERAPY AND IMPLICATIONS FOR CURRENT MANAGEMENT, Cancer, 73(2), 1994, pp. 476-482
Background. The combined modalities of surgery, chemotherapy, and radi
ation therapy have greatly improved the survival rate in childhood par
atesticular rhabdomyosarcoma, but the incidence of complications and l
ate side effects is a cause for concern. Methods. We reviewed the reco
rds of 18 patients treated for paratesticular rhabdomyosarcoma at St.
Jude Children's Research Hospital between 1962 and 1989. Patients with
Group I disease were treated with orchiectomy, retroperitoneal lymph
node dissection, and multiagent chemotherapy; more advanced cases also
received radiation therapy with concurrent chemotherapy. Results. Seq
uelae included esophageal and common bile duct stricture, inguinal ner
ve entrapment syndrome, and small bowel obstruction. Short stature was
found in all children whose spines were irradiated via para-aortic fi
elds (34-37 Gy) prior to puberty. Two of 18 patients died from treatme
nt complications and one from progressive disease. Conclusions. Multim
odality treatment offers an excellent prognosis in paratesticular rhab
domyosarcoma, but is associated with significant morbidity and mortali
ty rates. A discussion of therapy components and their application to
disease stages suggests possible appreaches to optimizing treatment fo
r this therapy-sensitive malignancy.