Issues in the local control of rhabdomyosarcoma

Background. Rhabdomyosarcoma (RMS) is a heterogeneous disease consisting of several different histologies arising from a variety of anatomic sites. Ap proximately half of the children who die of this tumor have failure at the primary site of involvement, making local control an important component of therapy. Procedure. Published literature and newly analyzed data from the Intergroup Rhabdomyosarcoma Study Group (IRSG) regarding local control of R MS were reviewed. Information regarding the role of various local control m odalities for different primary disease sites is presented along with new d irections for clinical research. Results. Local control rates For RMS avera ge 80% for group III tumors, with large variations seen for different anato mic sites. Important gains in functional outcome for certain sites such as gynecologic system and bladder/prostate have been achieved by optimizing th e use of the various treatment modalities. Local control at other sites suc h as the chest and extremities remains a problem. Conclusions. Advances in surgical and radiotherapy techniques coupled with multiagent chemotherapy a re providing improved local control with decreasing morbidity. Optimal outc ome is dependent on close collaboration between surgical, radiotherapy, and pediatric oncology specialists. Med. Pediatr. Oncol. 35:104-109, 2000. (C) 2000 Wiley-Liss, Inc.