Evaluation of the efficacy and toxicity of sequential platinum, etoposide and radiotherapy in the management of childhood rhabdomyosarcoma

الملخص EN

Treatment of group III rhabdomyosarcoma (RMS) is still a problem and patients who experience relapse have a uniform poor prognosis.

The aim of this pilot study was to evaluate the safety and efficacy of sequential platinum & etoposide chemotherapy regimen and radiation therapy in the management of previously treated or untreated childhood rhabdomyosarcoma.

It was started at the Unit of Radiation Oncology and E.N.T Department, Assiut University Hospital, Assiut, Egypt, since May 1994.

The treatment plan was to give 3 cycles of cisplatin 100mgDl& etoposide WOmgDl-3, all responding patients received a radical course of radiation treatment followed by another 3 cycles of chemotherapy.

Twelve evaluable patients had stage III RMS were included, eight boys and four girls their age ranged between 4-12 years with a mean of 8 years.

Pretreatment assessment included general examination, andE.N.Texaminations.

Rigidnasoscope andsinoscope were done in maxillary and orbital lesions.

Orbital and maxillary lesions were reported in 41.6% and 25% of cases respectively and the rest of the lesions occurred in the middle ear, parotid, bladder and retropharyngeal areas.

Embryonal RMS was the most common histological subtype reported in 75%, anaplastic subtype in 16.7% and alveolar subtype in 8.3%.

Clinical, Radiological (CT), and Sinoscopic reassessment after 3 cycles were done.

They composed of both general evaluation and E.N.

T examination andfollow up with sinoscope and rhinoscope.

They showed that complete response (CR) occurred in 6 patients out of 12 (50%), 5 patients (41.6%) hadpartial response (PR) and one patient (8.4%) had progressive disease (PD) with an overall response rate (CR + PR) of 91.6% (11 out of 12) after three cycles.

Radiation treatment was given to all responding patients and reassessment at the end of radiation treatment showed that all patients (1 lpatients) were in complete remission.

Another three cycles of chemotherapy were given two weeks after completion of radiation treatment In previously treated patients (5 children), CR was reported in 4 patients (80%) while in patients who had no previous treatment CR was reported in all patients (100%) Although the high response rate and lack of serious toxicity observed in our pilot study (especially in patients who had no previous treatment) are encouraging and promising, larger number of patients and longer period of follow-up are needed in a prospective randomized study.