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Pediatric rhabdomyosarcoma of the head and neck

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Opinion statement

Pediatric rhabdomyosarcoma is not exclusive to the head and neck. However, the unique anatomy of the head and neck requires special consideration and treatment modifications. The low incidence of these tumors has prevented the development of rigorous treatment protocols. Treatment strategies must be individualized on the basis of histopathologic subtype, prognostic indicators, tumor location, tumor extent, available clinical trial data, and hospital resources. The primary treatment of these tumors typically involves a combination of surgery, radiation, and chemotherapy. Advancements in surgical and radiotherapy techniques have reduced patient morbidity, whereas new chemotherapeutic protocols have improved local disease control and overall survival. Because of the infrequency and complexity of these tumors, patients may benefit from referral to centers with a comprehensive multidisciplinary team that has experience treating these tumors in the pediatric population. If possible, patients should be enrolled and treated on the current Children's Oncology Group protocol.

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References and Recommended Reading

  1. Dagher R, Helman L: Rhabdomyosarcoma: an overview. Oncologist 1999, 4:34–44.

    PubMed  CAS  Google Scholar 

  2. Walterhouse DO, Pappo AS, Baker KS, et al.: Rhabdomyosarcoma of the parotid region occurring in childhood and adolescence. A report from the Intergroup Rhabdomyosarcoma Study Group. Cancer 2001, 92:3135–3146.

    Article  PubMed  CAS  Google Scholar 

  3. Maurer HM, Beltangady M, Gehan EA, et al.: The Intergroup Rhabdomyosarcoma Study-I. Cancer 1988, 61:209–220.

    Article  PubMed  CAS  Google Scholar 

  4. Maurer HM, Gehan EA, Beltangady M, et al.: The Intergroup Rhabdomyosarcoma Study-II. Cancer 1993, 71:1904–1922.

    Article  PubMed  CAS  Google Scholar 

  5. Crist W, Gehan EA, Ragab AH, et al.: The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 1995, 13:610–630.

    PubMed  CAS  Google Scholar 

  6. Crist W, Anderson JR, Meza JL, et al.: Intergroup Rhabdomyosarcoma Study-IV: results for patients with nonmetastatic disease. J Clin Oncol 2001, 19:3091–3102. Important large clinical trial that provides outcomes for the latest therapies in early-stage pediatric rhabdomyosarcoma.

    PubMed  CAS  Google Scholar 

  7. Postec F, Bossard D, Distant F, Froelich P: Computerassisted navigation system in pediatric intranasal surgery. Arch Otolaryngol Head Neck Surg 2002, 128:797–800.

    PubMed  Google Scholar 

  8. Banhiran W, Casiano RR: Endoscopic sinus surgery for benign and malignant nasal and sinus neoplasms. Curr Opin Otolaryngol Head Neck Surg 2005, 13:50–54.

    Article  PubMed  Google Scholar 

  9. Yuen AP, Fan YW, Fung CF, Hung KN: Endoscopicassisted craniofacial resection of olfactory neuroblastoma. Head Neck 2005, 27:488–493.

    Article  PubMed  Google Scholar 

  10. Daya H, Chan HSL, Sirkin W, Forte V: Pediatric rhabdomyosarcoma of the head and neck: Is there a place for surgical management. Arch Otolaryngol Head Neck Surg 2000, 126:468–472. Excellent review of the role and timing of surgery in the management of rhabdomyosarcoma in an era of combination chemotherapy and radiation.

    PubMed  CAS  Google Scholar 

  11. Godzinski J, Flamant F, Rey A, et al.: Value of postchemotherapy bioptical verification of complete clinical remission in previously incompletely resected (stage I and IIpT3) malignant mesenchymal tumors in children: International Society of Pediatric Oncology 1984 Malignant Mesenchymal Tumors Study. Med Pediatr Oncol 1994, 22:22–26.

    Article  PubMed  CAS  Google Scholar 

  12. Genden EM, Buchbinder D, Chaplin JM, et al.: Reconstruction of the pediatric maxilla and mandible. Arch Otolaryngol Head Neck Surg 2000, 126:293–300.

    PubMed  CAS  Google Scholar 

  13. Lydaki E, Bolonaki I, Stiakaki E, Kambourakis A: Immediate free flap mandibular reconstruction in osteosarcoma of the mandible in childhood. Pediatr Hematol Oncol 2000, 17:335–340.

    Article  PubMed  CAS  Google Scholar 

  14. Stelnicki EJ, Boyd JB, Nott RL, et al.: Early treatment of severe mandibular hypoplasia with distraction mesenchymogenesis and bilateral free fibular flaps. J Craniofac Surg 2001, 12:337–348.

    Article  PubMed  CAS  Google Scholar 

  15. Houghton P, Cheshire P, Hallman J: Therapeutic efficacy of the topoisomerase I inhibitor 7-ethyl-10-(4-[1-peperidino]-1-piperidino)-carbonyloxy-camptothecin against human tumor xenografts: lack of cross-resistance in vivo in tumors with acquired resistance to the topoisomerase I inhibitor 9-dimethylaminomethy1-10-hydroxycamptothecin. Cancer Res 1993, 53:2823–2829.

    PubMed  CAS  Google Scholar 

  16. Houghton PJ, Chehire PJ, Hallman JD, et al.: Efficacy of topoisomerase I inhibitors, topotecan and irinotecan, administered at low dose levels in protracted schedules to mice bearing xenografts of humor tumors. Cancer Chemother Pharmacol 1995, 36:393–403.

    PubMed  CAS  Google Scholar 

  17. Furman WL, Stewart CF, Poquette CA, et al.: Direct translation of a protracted irinotecan schedule from a xenograft model to a phase I trial in children. J Clin Oncol 1999, 17:1815–1824.

    PubMed  CAS  Google Scholar 

  18. Rodriguez-Galindo C, Radomski K, Stewart CF, et al.: Clinical use of topoisomerase I inhibitors in anticancer treatment. Med Pediatr Oncol 2000, 35:385–402.

    Article  PubMed  CAS  Google Scholar 

  19. Parliament MB, Scrimger RA, Anderson SG, et al.: Preservation of oral health-related quality of life and salivary flow rates after inverse-planned intensitymodulated radiotherapy (IMRT) for head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004, 58:663–673.

    Article  PubMed  Google Scholar 

  20. Garden AS, Morrison WH, Rosenthal DI, et al.: Target coverage for head and neck cancers treated with IMRT: review of clinical experiences. Semin Radiat Oncol 2004, 14:103–109. Good review of the emerging role of IMRT as a method of reducing radiation morbidity in the head and neck region.

    Article  PubMed  Google Scholar 

  21. Hong TS, Tome WA, Chappell RJ, et al.: The impact of daily setup variations on head-and-neck intensitymodulated radiation therapy. Int J Radiat Oncol Biol Phys 2005, 61:779–788.

    Article  PubMed  Google Scholar 

  22. Michalski JM, Meza J, Breneman JC, et al.: Influence of radiation therapy parameters on outcome in children treated with radiation therapy for localized parameningeal rhabdomyosarcoma in Intergroup Rhabdomyosarcoma Study Group trials II through IV. Int J Radiat Oncol Biol Phys 2004, 59:1027–1038. Comprehensive review of the results of radiotherapy in IRS-II to-IV, which has been used to determine the treatment dosages needed for local control of rhabdomyosarcoma.

    Article  PubMed  Google Scholar 

  23. Parsons JT, Bova FJ, Fitzgerald CR, et al.: Radiation retinopathy after external-beam irradiation: analysis of time-dose factors. Int J Radiat Oncol Biol Phys 1994, 30:765–773.

    PubMed  CAS  Google Scholar 

  24. Monroe AT, Bhandare N, Morris CG, et al.: Preventing radiation retinopathy with hyperfractionation. Int J Radiat Oncol Biol Phys 2005, 61:856–864.

    Article  PubMed  Google Scholar 

  25. Bhandare N, Monroe AT, Morris CG, et al.: Does altered fractionation influence the risk of radiation-induced optic neuropathy. Int J Radiat Oncol Biol Phys 2005, 62:1070–1077.

    Article  PubMed  Google Scholar 

  26. Pappo AS, Meza JL, Donaldson SS, et al.: Treatment of localized nonorbital, nonparameningeal head and neck rhabdomyosarcoma: lessons learned from Intergroup Rhabdomyosarcoma studies III and IV. J Clin Oncol 2003, 21:638–645. Review of role of chemotherapy in IRS-III and -IV that has allowed the development of strategies of early institution of cyclophosphamide in certain low-risk groups to reduce tumor burden and treatment toxicity.

    Article  PubMed  Google Scholar 

  27. Donaldson SS, Meza J, Breneman JC, et al.: Results from the IRS-IV randomized trial of hyperfractionated radiotherapy in children with rhabdomyosarcoma-a report from the IRSG. Int J Radiat Oncol Biol Phys 2001, 51:718–728.

    Article  PubMed  CAS  Google Scholar 

  28. Oberlin O, Rey A, Anderson J, et al.: Treatment of orbital rhabdomyosarcoma: survival and late effects of treatment--results of an international workshop. J Clin Oncol 2001, 19:197–204.

    PubMed  CAS  Google Scholar 

  29. Raney RB, Asmar L, Vassilopoulou-Sellin R, et al.: Late complications of therapy in 213 children with localized, nonorbital soft-tissue sarcoma of the head and neck: a descriptive report from the Intergroup Rhabdomyosarcoma Studies (IRS)-II and-III. Med Pediatr Oncol 1999, 33:362–371. Large series with long-term follow-up that documents treatment-related toxic effects of therapy.

    Article  PubMed  CAS  Google Scholar 

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Gillespie, M.B., Marshall, D.T., Day, T.A. et al. Pediatric rhabdomyosarcoma of the head and neck. Curr. Treat. Options in Oncol. 7, 13–22 (2006). https://doi.org/10.1007/s11864-006-0028-3

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  • DOI: https://doi.org/10.1007/s11864-006-0028-3

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