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Adult Pleomorphic Rhabdomyosarcomas: Assessing Outcomes Associated with Radiotherapy and Chemotherapy Use in the
Vishruth K Reddy1, Varsha Jain1, Robert J Wilson Ii2
1Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA.
Sarcoma
|April 5, 2021
Summary
Treatment for localized adult pleomorphic rhabdomyosarcoma (PRMS) varies. Radiation therapy (RT) shows survival benefits, yet its use is inconsistent, particularly in older patients and females. Further research is needed.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Localized adult pleomorphic rhabdomyosarcoma (PRMS) is rare, leading to variable treatment approaches.
- Current guidelines suggest management similar to other high-grade soft tissue sarcomas (STS), involving surgery with perioperative radiation (RT) and potentially chemotherapy.
- Understanding practice patterns and outcomes is crucial for optimizing PRMS treatment.
Purpose of the Study:
- To assess treatment patterns for localized adult PRMS using the National Cancer Database (NCDB).
- To evaluate the impact of radiation therapy (RT) and chemotherapy on overall survival in PRMS patients.
- To identify predictors for the omission of RT and chemotherapy.
Main Methods:
- Retrospective analysis of 243 patients with stage II/III PRMS treated with surgical resection (2004-2015) from the NCDB.
- Multivariable logistic regression to identify predictors of RT and chemotherapy use.
- Kaplan-Meier and Cox proportional hazards analyses to assess the association of treatment with overall survival.
Main Results:
- Radiation therapy (RT) was utilized in 62% of patients not undergoing amputation and was associated with improved survival (5-year OS: 59% vs. 38%, P < 0.001).
- Chemotherapy was received by 44% of patients and showed a trend towards improved survival (5-year OS: 63% vs. 39%, P < 0.001), though not statistically significant in multivariate analysis.
- Predictors for RT omission included female gender and age ≥70; age ≥70 was also a predictor for chemotherapy omission.
Conclusions:
- A significant proportion of localized adult PRMS patients do not receive RT, indicating potential underutilization.
- Chemotherapy use was also heterogeneous.
- Findings highlight the potential survival benefits of RT and suggest further investigation into its underutilization and optimal application in PRMS.
