title: Tailor-made treatment combined with proton beam therapy for children with genitourinary/pelvic rhabdomyosarcoma.
abstract: BACKGROUND
  Rhabdomyosarcoma (RMS) is one of the most common soft tissue sarcomas among children. Patients who developed genitourinary/pelvic rhabdomyosarcoma (GU/P-RMS) have a higher complication ratio and relatively poorer event free survival, with local therapy being very important. While proton beam therapy (PBT) is expected to reduce co-morbidity, especially for children, this lacks firm evidence and analysis. We analyzed GU/P-RMS children who had undergone multimodal therapy combined with PBT at a single institution.
  
  
  METHODS
  We retrospectively reviewed charts of children with GU/P-RMS treated from January 2007 to May 2013 at the University of Tsukuba Hospital who had undergone multimodal therapy with PBT.
  
  
  RESULTS
  There were 5 children and their median age at diagnosis was 2.8 years (0.6-4.4 years). Primary sites were the bladder (2) and the prostate (3). All received neo-adjuvant chemotherapy and 3 underwent chemotherapy during PBT (Group Cx). All patients of Group Cx developed leukocytopenia (WBC <1000/μL). The median dose of PBT was 47.7 GyE (41.4-50.4 GyE). All patients survived by their last hospital visit (median, 36 months).
  
  
  CONCLUSIONS
  We analyzed multimodal treatment combined with PBT applied for GU/P-RMS. PBT was well tolerated and could be a plausible choice instead of photon therapy for this population.
authors.affiliation: Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan ; Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Fukushima
authors.affiliation: Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan ; Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Sakai
authors.affiliation: Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan ; Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Kobayashi
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Oshiro
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizumoto
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Hoshino
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Gotoh
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Urita
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Komuro
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Urology, Toho University Medical Center Ohashi Hospital, Meguro-Ku, Tokyo, Japan ; Department of Urology, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Sekido
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumoto
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan ; Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Sumazaki
keywords: Childhood malignancy; Genitourinary/pelvic tumor; Multimodal therapy; Proton-beam therapy; Rhabdomyosarcoma