DELAYED RADIATION THERAPY IN THE TREATMENT OF EMBRYONAL RHABDOMYOSARCOMA: A CASE REPORT AND LITERATURE REVIEW
.
Abstract
Background: Rhabdomyosarcoma (RMS) is a rare malignancy, accounting for 3% of all cancers in children, as the most common primary site for RMS is in the head and neck region. The most common histology in children is the embryonal subtype. The diagnosis of embryonal rhabdomyosarcoma in the head and neck region is primarily based on histopathology, following biopsy of the tumor. Despite the improved outcome based on the EFS and OS using the three different treatment modalities-chemotherapy, radiotherapy and surgical treatment, the survival of patients depends on their IRS groups—pathological and surgical.
Case presentation: We present a clinical case of a nine-year-old male with initial complaints of painful mass in the region near the left parotid gland. Clinical and paraclinical investigations were conducted for diagnostic purposes. The postoperative histopathology report given at the centre of primary wide excision and cervical neck dissection was embryonal rhabdomyosarcoma. The patient then was treated with adjuvant chemotherapy. The strategy of concurrent chemo-radiotherapy was not implemented, and radiotherapy was delayed for 4 months due to the patient's refusal of the treatment.
Results: The combination of surgery, chemotherapy and local control with radiotherapy achieved a good result in our patient.
Conclusions: Rhabdomyosarcoma (RMS) is a predominantly pediatric malignancy which can present throughout the body including the head and neck region. The use of radiation therapy is an important part of multimodality treatment for rhabdomyosarcoma
.
Keywords
Embryonal rhabdomyosarcoma, pediatric cancer, chemoradiotherapy, head and neck cancer, delay treatment.
- Casey DL, Wolden SL. Rhabdomyosarcoma of the Head and Neck: A Multimodal Approach. Journal of neurological surgery Part B, Skull base. 2018;79(1):58-64.
- Amer KM, Thomson JE, Congiusta D, et al. Epidemiology, Incidence, and Survival of Rhabdomyosarcoma Subtypes: SEER and ICES Database Analysis. Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 2019;37(10):2226-2230.
- Radzikowska J, Kukwa W, Kukwa A, Czarnecka A, Krzeski A. Rhabdomyosarcoma of the head and neck in children. Contemporary oncology (Poznan, Poland). 2015;19(2):98-107.
- Kern L, Henssen A, Eggert A, Scheer M. The Other Site of Rhabdomyosarcoma. Cancer medicine. 2024;13(20):e70348.
- Kendall GC, Watson S, Xu L, et al. PAX3-FOXO1 transgenic zebrafish models identify HES3 as a mediator of rhabdomyosarcoma tumorigenesis. eLife. 2018;7.
- Beverly Raney R, Walterhouse DO, Meza JL, et al. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 Protocol, Using Vincristine and Dactinomycin With or Without Cyclophosphamide and Radiation Therapy, for Newly Diagnosed Patients With Low-Risk Embryonal Rhabdomyosarcoma: A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group. Journal of Clinical Oncology. 2011;29(10):1312-1318.
- Ferrari A, De Salvo GL, Brennan B, et al. Synovial sarcoma in children and adolescents: the European Pediatric Soft Tissue Sarcoma Study Group prospective trial (EpSSG NRSTS 2005). Annals of Oncology. 2015;26(3):567-572.
- Totadri S, Bansal D, Donaldson SS, et al. Common queries in managing rhabdomyosarcoma in low- and middle-income countries: An Indo-North American collaboration. Pediatric blood & cancer. 2023;70(11):e30616.
- Frankart AJ, Breneman JC, Pater LE. Radiation Therapy in the Treatment of Head and Neck Rhabdomyosarcoma. Cancers. 2021;13(14).
- De B, Kinnaman MD, Wexler LH, Kramer K, Wolden SL. Central nervous system relapse of rhabdomyosarcoma. Pediatric blood & cancer. 2018;65(1).
