Bladder function after conservative surgery and high-dose rate brachytherapy for bladder-prostate rhabdomyosarcoma

Area of Science:

• Oncology
• Pediatric Urology
• Radiation Oncology

Background:

• Conservative surgery (CS) and brachytherapy (BT) aim to preserve organ function in bladder-prostate rhabdomyosarcoma (BP-RMS).
• High-dose rate (HDR) BT combined with CS is evaluated for local therapy in BP-RMS.

Purpose of the Study:

• To assess bladder function following HDR-BT combined with CS for BP-RMS.
• To evaluate the efficacy and safety of organ-sparing techniques in pediatric BP-RMS.

Main Methods:

• Prospective cohort study of BP-RMS patients (2014-2019) treated with HDR-BT (iridium-192, 27.5 Gy/5 fractions).
• Treatments included partial cystectomy (PC)+BT, percutaneous endoscopic polypectomy (PEP)+BT, or BT alone.
• Functional assessments included voiding parameters, continence, and urodynamics.

Main Results:

• 13 patients (median age 23 months) with localized embryonal BP-RMS were treated.
• At median 3.5-year follow-up, all patients were alive without relapse.
• Median bladder capacity was 86% of expected; 92% achieved daytime dryness, 62% day-and-night continence by age 4-9 years.

Conclusions:

• CS-HDR-BT is effective in preserving bladder function and achieving continence in pediatric BP-RMS.
• Minimally invasive approaches like PEP+BT or BT alone are suitable alternatives to extensive surgery.
• Organ-sparing strategies offer favorable functional outcomes for BP-RMS patients.