Implant brachytherapy: a novel treatment for recurrent orbital rhabdomyosarcoma.
BACKGROUND
Orbital rhabdomyosarcoma is the most common primary malignancy of the orbit in childhood. Tumor resection and exenteration were the preferred treatment modalities for rhabdomyosarcoma. In the past 20 years, however, combined local radiation and systemic chemotherapy have shown excellent survival results. Tumor recurrence after any of the aforementioned therapies is almost always fatal. We have developed a novel treatment for recurrent disease that has resulted in long-term survival for three patients.


METHODS
Three patients with recurrent orbital rhabdomyosarcoma were previously treated with primary radiation and chemotherapy. At the time of recurrence, exenteration and localized brachytherapy were performed. An individually molded poly(methylmethacrylate) (Lucite; E. I. du Pont de Nemours & Co., Wilmington, Del.) device loaded with radioactive iodine seeds delivered localized high-dose radiation, 6000 cGy over 6 days, to the orbit without irradiating the brain.


RESULTS
All patients are alive and free of disease with follow-up ranging from 4 years and 4 months to 8 years and 4 months.


CONCLUSIONS
A novel technique of delivering localized radiation to the orbit of three children with recurrent orbital rhabdomyosarcoma appears curative.
Abramson
D H
DH
Department of Ophthalmology, New York Hospital-Cornell Medical Center, New York, USA.
Fass
D
D
McCormick
B
B
Servodidio
C A
CA
Piro
J D
JD
Anderson
L L
LL
D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D007457:Iodine Radioisotopes