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Prognostic factors in head and neck rhabdomyosarcoma
James H Simon1, Arnold C Paulino, Russell B Smith
1Department of Radiation Oncology, University of Iowa Hospital & Clinics, 200 Hawkins Drive, Room W189Z, GH, Iowa City 52242, USA.
Background:
Rhabdomyosarcoma comprises less than 1% of all head and neck cancer. The purpose of our study is to review our institutional experience in this disease and to identify possible prognostic factors for patients with head and neck rhabdomyosarcoma.
Methods:
One hundred forty patients with rhabdomyosarcoma were identified from 1955-1999 within the tumor registry. Of these cases, 49 (35%) were noted to be primary head and neck rhabdomyosarcomas. Retrospective chart reviews were completed to obtain the following data: age, gender, site, tumor size, histologic findings, Intergroup Rhabdomyosarcoma Study Group, treatment, local control, and survival.
Results:
The 5-year overall survival and local control rates were 60% +/- 14% and 70% +/- 14%, respectively. Tumor size < or =5 cm (p =.014) and age < or =11 years (p =.036) were predictive of improved survival, whereas age < or =11 years was predictive of improved local control (p =.006). Children < or =11 years with a < or =5-cm tumor have the best overall survival, whereas patients >11 years with a tumor >5 cm have the worst survival. The 5-year survival was intermediate for children < or =11 years with a >5-cm tumor and patients >11 years with a < or =5-cm tumor. Radiotherapy treatment duration < or =45 days in group III disease was associated with improved overall survival but not local control. For the six patients with group I or II disease, who did not receive initial chemotherapy, five had relapses at the primary and/or distant sites.
Conclusions:
Improvement in outcome was obtained with multimodality treatment regimens for head and neck rhabdomyosarcoma. Both tumor size and age of patient were found to influence survival.