Excessive treatment failures in patients with parameningeal rhabdomyosarcoma with reduced-dose cyclophosphamide and delayed radiotherapy

John T. Lucas, Alberto S. Pappo, Jianrong Wu, Daniel J. Indelicato, Matthew J. Krasin

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Pediatric patients with parameningeal rhabdomyosarcoma and high-risk features are recommended to receive radiotherapy at initiation of protocol therapy due to concerns about the increased risk of local and leptomeningeal failure from treatment delay. We report our early experience on a multi-institutional prospective trial incorporating delayed primary site radiation and reduced dose cyclophosphamide in all patients with parameningeal tumors. We observed an excessive number of locoregional treatment failures following this approach and have subsequently amended our trial to move radiation therapy upfront for those patients with high-risk features. We suggest that investigators should be vigilant for treatment failure given our early prospective experience with delayed radiotherapy and reduced dose cyclophosphamide.

Original languageEnglish
Pages (from-to)387-390
Number of pages4
JournalJournal of Pediatric Hematology/Oncology
Volume40
Issue number5
DOIs
StatePublished - Jul 1 2018

Bibliographical note

Funding Information:
Received for publication June 7, 2017; accepted December 21, 2017. From the Departments of *Radiation Oncology; †Oncology; ‡Biostatistics, St Jude Children’s Research Hospital, Memphis, TN; and §Department of Radiation Oncology, University of Florida Health Proton Therapy Institute, Jacksonville, FL. Supported in part by the St Jude Children’s Research Hospital Cancer Center Grant P30CA021765. The authors declare no conflict of interest. Reprints: John T. Lucas Jr, MS, MD, Department of Radiation Oncology, St Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 210, Memphis, TN 38105-3678 (e-mail: john.lucas@stjude.org). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • cyclophosphamide
  • parameningeal tumors
  • radiotherapy
  • rhabdomyosarcoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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