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Results of rhabdomyosarcoma treatment in a developing country
Z Karakas1, L Agaoglu, B Biner
1Division of Pediatric Haematology/Oncology, Istanbul School of Medicine, Turkey.
Insights
This study on pediatric rhabdomyosarcoma highlights challenges in developing countries. High loss to follow-up rates and treatment compliance issues impact outcomes for children with this rare cancer.
Area of Science:
- Pediatric Oncology
- Cancer Research
- Clinical Medicine
Background:
- Rhabdomyosarcoma is a rare pediatric malignancy with diverse primary sites and histopathologic subtypes.
- Treatment protocols, such as the Intergroup Rhabdomyosarcoma Study (IRS) II and III, guide management.
- Challenges in cancer care, particularly in developing nations, affect patient outcomes.
Purpose of the Study:
- To analyze treatment outcomes and challenges for pediatric rhabdomyosarcoma patients treated between 1980-1999.
- To identify factors influencing survival and relapse rates in this cohort.
- To underscore the difficulties in cancer treatment compliance in developing countries.
Main Methods:
- Retrospective analysis of 51 children diagnosed with rhabdomyosarcoma.
- Data collection on patient demographics, primary tumor sites, histopathology, and Intergroup Rhabdomyosarcoma Study (IRS) staging.
- Review of treatment modalities including surgery, radiotherapy, and chemotherapy protocols.
Main Results:
- Head and neck (31.4%) and genitourinary (21.6%) were common primary sites; embryonal subtype predominated (80.4%).
- Most patients were IRS group III (47%) and IV (25.5%); only 27.5% had primary tumor resection.
- High loss to follow-up (66.7%) complicated outcome assessment, with 41.2% of observed patients dying and 52.9% relapsing.
Conclusions:
- Pediatric rhabdomyosarcoma treatment in developing countries faces significant hurdles, including high patient attrition and treatment non-compliance.
- Effective cancer care requires addressing systemic issues that lead to poor follow-up and suboptimal treatment delivery.
- Improved strategies are needed to enhance patient adherence and complete treatment regimens for better outcomes in pediatric rhabdomyosarcoma.
Abstract:
Fifty-one children (median age: 4.5 years; 4 months-16 years) diagnosed with rhabdomyosarcoma were treated in our center between 1980-1999. The primary sites were head and neck in 31.4%, the genito-urinary system in 21.6%, and extremities in 9.8% of the patients. The histopathologic subtypes were embryonal in 80.4%, alveolar in 9.8%, and undifferentiated in 9.8%. The majority of the patients were considered group III (47%) and group IV (25.5%) according the criteria of the Intergroup Rhabdomyosarcoma Study (IRS). Primary total tumour resection was performed in only 27.5% of the patients. The patients were treated with assigned regimens of IRS II and IRS III protocols. Radiotherapy was applied to 92.1% of the patients. Thirty-four patients (66.7%) were lost to follow up, and of the remaining 17 patients, 7 patients (41.2%) died, relapse occurred in 9 patients (52.9%) and 10 patients (58.8%) are alive. The percentage of cases lost to follow up during the first 10 years and the following 9 years of the study were 77.4% and 50%, respectively. In compliance with cancer treatment remains a major problem in developing countries.