Multidisciplinary treatment of embryonal rhabdomyosarcoma in children: a progress report

Fifty-nine patients under 21 years of age with embryonal rhabdomyosarcoma were treated according to a multidisciplinary protocol (T-2). The protocol consisted of surgical removal of the tumor, if possible, determination of clinicopathologic stages of the disease followed by radiotherapy for stages IB to IV, and chemotherapy. Radiation therapy was given in the range of 4,500--7,000 rad. The chemotherapy given for 2 years consisted of cycles of sequential administration of dactinomycin, adriamycin, vincristine, and cyclophosphamide. Forty-five of the patients (76%) are alive with no evidence of disease for 6 to 100 months (median follow-up of 57 ml). These include 19 of the 21 patients with stage IA (localized tumors, completely resected), 10 of the 10 stage IB (resected tumors, microscopic residual), 8 of the 9 stage II (unresectable tumors), 7 of the 14 stage III (unresectable tumors plus regional node involvement), and 1 of the 5 patients with stage IV (metastatic) disease. These results are superior to those achieved in 1960--70 at the Memorial Sloan-Kettering Cancer Center.