title: A novel local treatment strategy for advanced stage head and neck rhabdomyosarcomas in children: results of the AMORE protocol.
abstract: The AMORE protocol is a local treatment regimen for head and neck rhabdomyosarcomas (HNRMS), consisting of Ablative surgery, Moulage technique brachytherapy and surgical Reconstruction. The aim of AMORE is to intensify local treatment for children with HNRMS and to avoid external beam radiation therapy (EBRT) and its long-term sequelae. All children with primary irresectable, non-orbital HNRMS in whom EBRT was indicated, were evaluated for the feasibility of AMORE. In 20 children, AMORE was performed (15 with parameningeal disease and five with non-parameningeal disease). Complete remission was achieved in all 20 patients. Local complications were limited. 5 patients experienced a local relapse and 1 patient developed distant metastases. Estimated 5-year OS and EFS were 67.5 and 64.1% for the entire group, and 64.2 and 60.0% for the parameningeal subgroup. We conclude that the AMORE protocol is a feasible strategy, with a good local control rate. Long-term sequelae of EBRT might be avoided although, to date, the follow-up is too short for definitive conclusions regarding these sequelae.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Buwalda
authors.forename: P F
authors.initials: PF
authors.lastname: Schouwenburg
authors.forename: L E C M
authors.initials: LE
authors.lastname: Blank
authors.forename: J H M
authors.initials: JH
authors.lastname: Merks
authors.forename: M P
authors.initials: MP
authors.lastname: Copper
authors.forename: S D
authors.initials: SD
authors.lastname: Strackee
authors.forename: P A
authors.initials: PA
authors.lastname: Voûte
authors.forename: H N
authors.initials: HN
authors.lastname: Caron
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019651:Plastic Surgery Procedures; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome