Combined chemotherapy in childhood rhabdomyosarcoma

Twenty-two children with rhabdomyosarcoma were treated with combination chemotherapy using vincristine, actinomycin D, and cyclophosphamide for varying time periods. Chemotherapy, usually combined with radiation therapy, was given to early stage patients after they had had a com plete or partial tumor resection. Three of nine patients who had widespread metastatic (stage III) disease at initiation of therapy had complete tumor regression and four of nine had partial tumor regression. However, the median durations of response and survival were brief (3 and 8 months respectively). Five patients with localized resectable (stage I) disease have survived without evidence of tumor recurrence from 33 to 69 months after their initial diagnosis. Of eight patients with incompletely resected regional (stage IIB) disease, one has survived without disease recurrence for 36 months, thought the median survival time of the remaining seven patients was 14 months. In stage IIB patients the duration of response was proportional to the duration of chemotherapy which suggests that chemotherapy should be given for at least 18-24 months.