Children with Vesical Rhabdomyosarcoma (RMS) Treated by Partial Cystectomy with Neoadjuvant or Adjuvant Chemotherapy, With or Without Radiotherapy A Report from the Intergroup Rhabdomyosarcoma Study (IRS) Committee
| Autor: | Harold M. Maurer, Moody D. Wharam, Walter Lawrence, Jean Johnston, Bruce Webber, R. B. Raney, R. J. Andrasy, Thom E. Lobe, Daniel M. Hays, Eugene S. Wiener |
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| Rok vydání: | 1995 |
| Předmět: |
Oncology
Male medicine.medical_specialty Adolescent Cyclophosphamide Adjuvant chemotherapy Urinary system medicine.medical_treatment Pediatric Hematology/Oncology Urinary Bladder Cystectomy Prostate Rhabdomyosarcoma Internal medicine Antineoplastic Combined Chemotherapy Protocols Rhabdomyosarcoma medicine Humans Child Retrospective Studies Urinary bladder business.industry Infant Hematology medicine.disease Combined Modality Therapy Surgery Radiation therapy medicine.anatomical_structure Urinary Bladder Neoplasms Bladder augmentation Vincristine Child Preschool Pediatrics Perinatology and Child Health Dactinomycin Female business medicine.drug |
| Zdroj: | Journal of Pediatric Hematology/Oncology. 17:46-52 |
| ISSN: | 1077-4114 |
| DOI: | 10.1097/00043426-199502000-00008 |
| Popis: | PURPOSE Children with bladder rhabdomyosarcoma (RMS) are currently treated with primary chemotherapy and usually with local irradiation. More than 30% of this group ultimately require total cystectomy. The purpose of this study was to review the results of the use of partial as opposed to total cystectomy in 40 patients with bladder RMS during Intergroup Rhabdomyosarcoma Study (IRS)-I, -II, and -III (1972-1989). PATIENTS AND METHODS A total of 171 children with primary RMS of the bladder were enrolled in the IRS during this interval. Partial cystectomy was performed in 40, in 33 before any other therapy and in seven after 10-57 weeks of chemotherapy (primarily vincristine, actinomycin-D, and cyclophosphamide, i.e., VAC) +/- radiotherapy. Surviving patients have been observed for 4-22 years. RESULTS Thirty-one of 40 patients (78.5%) have been disease free for 2-16 years. Survival among all other IRS cases with bladder RMS during the same interval was 79.5%. Of the 31 surviving patients, one required secondary total cystectomy and two required bladder augmentation procedures for benign bladder contracture. Three quarters of the total group of living patients who have undergone partial cystectomy are without bladder-related symptoms or demonstrable lower urinary tract disease. The remaining patients have a history of functional bladder problems related to contracture or incontinence. CONCLUSIONS Partial cystectomy is an alternative to total cystectomy for bladder RMS when the tumor site makes it anatomically feasible. In such patients, it should be considered before total cystectomy and in patients with persistent areas of questionable residual tumor after otherwise apparently successful regimens of primary chemotherapy +/- radiotherapy. |
| Databáze: | OpenAIRE |
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