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    What constitutes optimal therapy for patients with rhabdomyosarcoma of the female genital tract

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    Authors
    Arndt, C A.
    Donaldson, S S.
    Anderson, J R.
    Andrassy, R J.
    Laurie, F
    Link, M P.
    Raney, R B.
    Maurer, H M.
    Crist, W M.
    UMass Chan Affiliations
    Quality Assurance Review Center
    Document Type
    Journal Article
    Publication Date
    2001-06-01
    Keywords
    Health Services Administration
    Neoplasms
    Oncology
    Radiology
    
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    Link to Full Text
    http://dx.doi.org/10.1002/1097-0142(20010615)91:12<2454::AID-CNCR1281>3.0.CO;2-C
    Abstract
    BACKGROUND: Factors affecting outcome for rhabdomyosarcoma (RMS) of the female genital tract in patients treated on Intergroup Rhabdomyosarcoma Study Group (IRSG) protocols I-IV were evaluated to define optimal therapy. METHODS: Records of 151 patients with tumors of the female genital tract who were treated on IRSG protocols I-IV were reviewed for details regarding chemotherapy, surgery, radiotherapy (RT), and outcome. RESULTS: The overall 5-year survival was 82%, (87% for patients with locoregional tumors). Chemotherapy was primarily vincristine, actinomycin-D, and cyclophosphamide (VAC) based. Local therapy was surgery alone in 42% of patients, surgery plus RT in 19% of patients, biopsy plus RT in 12% of patients, and biopsy without RT in 21% of patients. The rate of hysterectomy decreased from 48% in IRS-I/II to 22% in IRS-III/IV with an increase in the use of RT from 23% in IRS-II to 45% in IRS-IV and continued excellent survival. Many patients with vaginal primary tumors received delayed RT or had it omitted on later studies with excellent outcome. For patients with localized embryonal/botryoid tumors, there were no significant differences in 5-year survival among patients with tumors at different sites or among patients treated on IRS-I-IV. In patients with Group I-III tumors, 43% of deaths were from toxicity. Analysis of prognostic factors, with toxic deaths censored, revealed that an age of 1-9 years at the time of diagnosis, noninvasive tumors, and the use of IRS-II or IRS-IV treatments were associated significantly with better outcome. Patients ages 1-9 years fared best (5-year survival of 98%) and patients outside of this age range especially benefited from the intensified therapy used in IRS-III or IRS-IV (5-year survival of 67% on the IRS-I/II vs. 90% in IRS-III/IV). CONCLUSIONS: Localized female genital RMS usually is curable with combination chemotherapy, a conservative surgical approach, and the use of RT for selected patients.
    Source
    Cancer. 2001 Jun 15;91(12):2454-68.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46511
    PubMed ID
    11413538
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