Delayed-accelerated hyperfractionated radiation therapy for advanced-stage or high-risk rhabdomyosarcoma.
The treatment of six patients with advanced-stage or high-risk rhabdomyosarcoma (RMS) is described. These patients were treated with a delayed-accelerated hyperfractionated radiation therapy (DAHFRT) regimen which delivers 5200 cGy over 20 treatment days. Acceptable early toxicity was noted when radiation therapy was given after a full course of chemotherapy and major attempts at resection of the primary tumor. The DAHFRT regimen has inherent biological and time-intensity advantages compared to other fractionation schemes which may be exploited to improve local control. The DAHFRT regimen should be considered as an alternate fractionation scheme for RMS patients and a possible foundation from which dose-escalation of radiation therapy may be attempted using advanced treatment planning technology. Late effects of high-dose radiation therapy, although a major concern, should assume less priority given the high local failure rates of advanced-stage patients and the advent of conformed radiation therapy treatment planning and delivery which can be used to reduce treatment-related toxicity.
Merchant
T E
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Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D011879:Radiotherapy Dosage; D012208:Rhabdomyosarcoma / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome