Localized paediatric orbital rhabdomyosarcoma: influence of imaging on treatment.
OBJECTIVE
Orbital rhabdomyosarcoma is the most common primary malignant orbital tumour in children and has a good prognosis. The purpose of this paper was to review the imaging and consequent treatment of patients with localized orbital rhabdomyosarcoma from around the U.K.


METHODS
Patients were identified through the U.K. Children's Cancer Study Group (UKCCSG) database. Investigations and therapy were dictated by the Malignant Mesenchymal Tumour '89 (MMT89) protocol. Imaging and radiological reports of 16 patients from 12 centres were reviewed. The number of patients receiving radiotherapy, timing of radiotherapy, and adherence to treatment protocols were assessed.


RESULTS
Local radiologists' reports and imaging techniques varied between sequential examinations and centres. The imaging was adequate for management. No reports quoted measurements of the tumours. Treatment protocols were not always followed rigidly with regard to a residual mass at day 80 post-diagnosis. However, the protocol was not explicit for all outcomes. Fifteen out of 16 patients eventually received radiotherapy.


CONCLUSIONS
There is no standardization of imaging between centres. The presence or absence of a post-therapeutic residue should be stated in the radiology report. Further investigation is needed to differentiate between fibrosis and recurrent tumour. Radiotherapy for residual mass at day 80 is probably more important than standardizing radiological technique.
Burns
B J
BJ
Radiology Department, John Radcliffe Hospital, Oxford, UK. bburns@doctors.org.uk
McHugh
K
K
McDowell
H P
HP
Anslow
P
P
Mitchell
C
C
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012074:Remission Induction; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods