Ten-year experience with childhood rhabdomyosarcoma

The ten-year (1965-1975) experience of the Pediatric Tumor Clinic with 14 cases of proven CRM was reviewed. Seven cases seen prior to 1970 acted as control. They were treated by surgery and X--ray therapy alone (one received one chemotherapeutic agent). Seven other cases seen after 1970 adhered to a strict protocol of therapy. After surgery (resection or biopsy), roentgenological and hematological survey for diagnosis and staging, they received curative radiotherapy locally in doses of 5,200 r to 6,000 r. Concomitantly a regimen of multiple chemotherapeutic agents (vincristine, dactinomycin and cyclophosphamide) was administered according to the protocol followed at the M.D. Anderson Hospital, Houston. Only one of the seven controls is alive and free of disease for 9 years. Only one of the seven cases who adhered to the protocol died. The other six are alive and free of disease for periods of one to two and a half years (one has a 4 months follow-up so far). One of the six cases presenting with a solitary pulmonary metastasis had a lobectomy 2 and a half years after start of treatment, as no new metastasis developed. Another, presenting with a local recurrence after excision is alive and free of disease 2 years after the star of treatment with the protocol. The results of treatment of CRM with the protocol adopted show a significant improvement in terms of local recurrences, distant metastasis and survival rates.