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Embryonal rhabdomyosarcoma with metastases confined to the lungs: Report from the CWS Study Group.
Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum Stuttgart, Germany.
Department of Pediatric Radiology, Olgahospital, Klinikum Stuttgart, Germany.
Department of Radiotherapy, University of Muenster, Muenster, Germany.
Department of Thoracic Surgery, Klinik Schillerhoehe, Gerlingen, Germany.
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2011 (English)In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 56, no 5, 725-732 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Embryonal rhabdomyosarcoma [RME] is the most common pediatric soft tissue sarcoma. Whereas the prognosis of localized rhabdomyosarcoma has improved, it remains poor for metastatic disease. METHODS: We analyzed RME-patients with isolated pulmonary metastases [PRME] treated in four consecutive CWS-trials. Treatment included multiagent chemotherapy and local treatment of the primary tumor. Therapy of lung metastases after induction chemotherapy depended on response and individual decisions. RESULTS: Twenty-nine patients <21 years had PRME. Their median age was six years, the median follow-up nine years. Twenty-eight children had their primary tumor located in an unfavorable site and 22 of the primaries were >5 cm. In addition to conventional chemotherapy, seven patients received high-dose treatment and eight patients oral metronomic chemotherapy. The lung metastases were in remission after induction chemotherapy in 22 individuals. 19 patients received no local treatment of metastases; 3 patients had pulmonary metastasectomy and lung radiation was administered to 9 individuals. In total, 24/29 patients achieved a complete remission [CR]. Actuarial 5-year event-free and overall survival for all patients was 37.9 ± 18% and 48.7 ± 18%, respectively; it was 45.8 ± 20% and 58.3 ± 20% for the 24 patients who achieved a CR. Local treatment of metastases had no impact on the failure pattern. Younger age, good response, achievement of CR and maintenance-treatment were favorable prognostic factors in univariate analysis. CONCLUSIONS: Children with PRME have a fair prognosis. Local treatment of metastases did not improve outcome in our sample. Metronomic treatment may be an attractive option for PREM-patients. [correction made here after initial online publication].

Place, publisher, year, edition, pages
2011. Vol. 56, no 5, 725-732 p.
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Medical and Health Sciences
URN: urn:nbn:se:uu:diva-140795DOI: 10.1002/pbc.22862ISI: 000288132100004PubMedID: 21061312OAI: oai:DiVA.org:uu-140795DiVA: diva2:384405
Available from: 2011-01-09 Created: 2011-01-09 Last updated: 2011-08-22Bibliographically approved

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