Long-term results in children with head and neck rhabdomyosarcoma

A report from the Italian Soft Tissue Sarcoma Committee

Maria Carmen Affinita, Andrea Ferrari, Giuseppe Maria Milano, Giovanni Scarzello, Francesco De Leonardis, Luca Coccoli, Roberta Pericoli, Eleonora Basso, Ilaria Zanetti, Angela Scagnellato, Gianni Bisogno

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Rhabdomyosarcoma (RMS) occurring at nonparameningeal head and neck (NPM-HN) sites carries a better prognosis than parameningeal RMS and some other sites. We analyzed the treatments administered and results obtained in patients with localized NPM-HN RMS, included in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee (STSC), in an effort to identify prognostic factors that could facilitate the tailoring of treatment.

METHODS: Sixty-six patients up to 18 years of age with previously untreated, localized NPM-HN RMS were prospectively registered in three consecutive protocols: RMS79, RMS88, and RMS96. Primary surgery was recommended when complete tumor resection was deemed feasible without mutilations. In other cases, only a biopsy was performed, followed by chemotherapy and delayed surgery and/or radiotherapy (RT).

RESULTS: NPM-HN RMS showed favorable characteristics: 72.7% were <5 cm, 72.7% were T1, and 80.3% were N0. With a median follow-up of 16 years (range 7-27), the 10-year progression-free survival and overall survival for the whole group were 65.1% (confidence interval [CI]: 52.3-75.3) and 74.2% (CI: 61.8-83.1). Progressive improvement has been seen in the successive protocols. Age and RT emerged as independent prognostic factors. The group of young children (age <l year) not irradiated was at high risk of failure.

CONCLUSION: The experience of the Italian STSC confirms that NPM-HN RMS has a favorable prognosis, which has improved over the years due to a better, multimodal treatment approach. RT has an important role, but different modalities such as proton therapy and brachytherapy should be explored in systematic ways in very young children.

Original languageEnglish
JournalPediatric Blood and Cancer
Volume65
Issue number3
Early online dateNov 8 2017
DOIs
Publication statusPublished - Mar 2018

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Rhabdomyosarcoma
Sarcoma
Neck
Head
Radiotherapy
Confidence Intervals
Proton Therapy
Combined Modality Therapy
Brachytherapy
Disease-Free Survival
Biopsy
Drug Therapy
Survival
Therapeutics
Neoplasms

Keywords

  • Journal Article

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Long-term results in children with head and neck rhabdomyosarcoma : A report from the Italian Soft Tissue Sarcoma Committee. / Affinita, Maria Carmen; Ferrari, Andrea; Milano, Giuseppe Maria; Scarzello, Giovanni; De Leonardis, Francesco; Coccoli, Luca; Pericoli, Roberta; Basso, Eleonora; Zanetti, Ilaria; Scagnellato, Angela; Bisogno, Gianni.

In: Pediatric Blood and Cancer, Vol. 65, No. 3, 03.2018.

Research output: Contribution to journalArticle

Affinita, Maria Carmen ; Ferrari, Andrea ; Milano, Giuseppe Maria ; Scarzello, Giovanni ; De Leonardis, Francesco ; Coccoli, Luca ; Pericoli, Roberta ; Basso, Eleonora ; Zanetti, Ilaria ; Scagnellato, Angela ; Bisogno, Gianni. / Long-term results in children with head and neck rhabdomyosarcoma : A report from the Italian Soft Tissue Sarcoma Committee. In: Pediatric Blood and Cancer. 2018 ; Vol. 65, No. 3.
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abstract = "BACKGROUND: Rhabdomyosarcoma (RMS) occurring at nonparameningeal head and neck (NPM-HN) sites carries a better prognosis than parameningeal RMS and some other sites. We analyzed the treatments administered and results obtained in patients with localized NPM-HN RMS, included in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee (STSC), in an effort to identify prognostic factors that could facilitate the tailoring of treatment.METHODS: Sixty-six patients up to 18 years of age with previously untreated, localized NPM-HN RMS were prospectively registered in three consecutive protocols: RMS79, RMS88, and RMS96. Primary surgery was recommended when complete tumor resection was deemed feasible without mutilations. In other cases, only a biopsy was performed, followed by chemotherapy and delayed surgery and/or radiotherapy (RT).RESULTS: NPM-HN RMS showed favorable characteristics: 72.7{\%} were <5 cm, 72.7{\%} were T1, and 80.3{\%} were N0. With a median follow-up of 16 years (range 7-27), the 10-year progression-free survival and overall survival for the whole group were 65.1{\%} (confidence interval [CI]: 52.3-75.3) and 74.2{\%} (CI: 61.8-83.1). Progressive improvement has been seen in the successive protocols. Age and RT emerged as independent prognostic factors. The group of young children (age CONCLUSION: The experience of the Italian STSC confirms that NPM-HN RMS has a favorable prognosis, which has improved over the years due to a better, multimodal treatment approach. RT has an important role, but different modalities such as proton therapy and brachytherapy should be explored in systematic ways in very young children.",
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T1 - Long-term results in children with head and neck rhabdomyosarcoma

T2 - A report from the Italian Soft Tissue Sarcoma Committee

AU - Affinita, Maria Carmen

AU - Ferrari, Andrea

AU - Milano, Giuseppe Maria

AU - Scarzello, Giovanni

AU - De Leonardis, Francesco

AU - Coccoli, Luca

AU - Pericoli, Roberta

AU - Basso, Eleonora

AU - Zanetti, Ilaria

AU - Scagnellato, Angela

AU - Bisogno, Gianni

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2018/3

Y1 - 2018/3

N2 - BACKGROUND: Rhabdomyosarcoma (RMS) occurring at nonparameningeal head and neck (NPM-HN) sites carries a better prognosis than parameningeal RMS and some other sites. We analyzed the treatments administered and results obtained in patients with localized NPM-HN RMS, included in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee (STSC), in an effort to identify prognostic factors that could facilitate the tailoring of treatment.METHODS: Sixty-six patients up to 18 years of age with previously untreated, localized NPM-HN RMS were prospectively registered in three consecutive protocols: RMS79, RMS88, and RMS96. Primary surgery was recommended when complete tumor resection was deemed feasible without mutilations. In other cases, only a biopsy was performed, followed by chemotherapy and delayed surgery and/or radiotherapy (RT).RESULTS: NPM-HN RMS showed favorable characteristics: 72.7% were <5 cm, 72.7% were T1, and 80.3% were N0. With a median follow-up of 16 years (range 7-27), the 10-year progression-free survival and overall survival for the whole group were 65.1% (confidence interval [CI]: 52.3-75.3) and 74.2% (CI: 61.8-83.1). Progressive improvement has been seen in the successive protocols. Age and RT emerged as independent prognostic factors. The group of young children (age CONCLUSION: The experience of the Italian STSC confirms that NPM-HN RMS has a favorable prognosis, which has improved over the years due to a better, multimodal treatment approach. RT has an important role, but different modalities such as proton therapy and brachytherapy should be explored in systematic ways in very young children.

AB - BACKGROUND: Rhabdomyosarcoma (RMS) occurring at nonparameningeal head and neck (NPM-HN) sites carries a better prognosis than parameningeal RMS and some other sites. We analyzed the treatments administered and results obtained in patients with localized NPM-HN RMS, included in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee (STSC), in an effort to identify prognostic factors that could facilitate the tailoring of treatment.METHODS: Sixty-six patients up to 18 years of age with previously untreated, localized NPM-HN RMS were prospectively registered in three consecutive protocols: RMS79, RMS88, and RMS96. Primary surgery was recommended when complete tumor resection was deemed feasible without mutilations. In other cases, only a biopsy was performed, followed by chemotherapy and delayed surgery and/or radiotherapy (RT).RESULTS: NPM-HN RMS showed favorable characteristics: 72.7% were <5 cm, 72.7% were T1, and 80.3% were N0. With a median follow-up of 16 years (range 7-27), the 10-year progression-free survival and overall survival for the whole group were 65.1% (confidence interval [CI]: 52.3-75.3) and 74.2% (CI: 61.8-83.1). Progressive improvement has been seen in the successive protocols. Age and RT emerged as independent prognostic factors. The group of young children (age CONCLUSION: The experience of the Italian STSC confirms that NPM-HN RMS has a favorable prognosis, which has improved over the years due to a better, multimodal treatment approach. RT has an important role, but different modalities such as proton therapy and brachytherapy should be explored in systematic ways in very young children.

KW - Journal Article

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DO - 10.1002/pbc.26876

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VL - 65

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 3

ER -