Pediatric Hematology and Oncology, Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Cancer Control. 2024 Jan-Dec;31:10732748241240655. doi: 10.1177/10732748241240655.
Treatment for parameningeal rhabdomyosarcoma (PM-RMS) has been a challenge since local control is difficult. The goal of this study was to analyse the impact of different local treatment approaches on childhood PM-RMS patients and help dispel the doubt that whether secondary radical surgery (SRS) should be encouraged in the management of PM-RMS.
A total of 17 children with PM-RMS who received unified systemic chemotherapy and individualized local therapy such as radiotherapy (RT) and/or SRS were included in this retrospective study. The overall survival (OS) and event free survival (EFS) were compared between groups adopting different local strategies.
The 3-year OS and EFS of our PM-RMS patients was 75.5% and 56.5% respectively. The OS and EFS of patients who received SRS were both significantly lower than that of the non-SRS group (3-year OS: 50.0% vs 90.0%, = .031; 3-year EFS: 33.3% vs 60.6%, = .020). The OS and EFS of the patients who received RT was higher than that of the patients of the non-RT group (3-year OS: 85.6% vs 0%, = .001; 3-year EFS: 64.0% vs 0%, = .011).
This study illustrates that SRS was associated with poor prognosis of PM-RMS and should not be routinely performed. Optimized RT strategies along with more intensive chemotherapy may be alternative options to improve the survival of patients with PM-RMS. Multi-center, large sample and prospective studies are needed to further validate these findings.
由于局部控制困难,因此治疗脑脊膜横纹肌肉瘤(PM-RMS)一直是一个挑战。本研究的目的是分析不同局部治疗方法对儿童 PM-RMS 患者的影响,并消除是否应鼓励在 PM-RMS 管理中采用二次根治性手术(SRS)的疑虑。
本回顾性研究共纳入 17 例接受统一全身化疗和个体化局部治疗(如放疗(RT)和/或 SRS)的 PM-RMS 患儿。比较采用不同局部策略的各组之间的总生存率(OS)和无事件生存率(EFS)。
我们的 PM-RMS 患者的 3 年 OS 和 EFS 分别为 75.5%和 56.5%。接受 SRS 的患者的 OS 和 EFS 均明显低于非 SRS 组(3 年 OS:50.0% vs 90.0%, =.031;3 年 EFS:33.3% vs 60.6%, =.020)。接受 RT 的患者的 OS 和 EFS 均高于未接受 RT 的患者(3 年 OS:85.6% vs 0%, =.001;3 年 EFS:64.0% vs 0%, =.011)。
本研究表明,SRS 与 PM-RMS 的预后不良相关,不应常规进行。优化的 RT 策略结合更强化的化疗可能是改善 PM-RMS 患者生存的替代选择。需要多中心、大样本和前瞻性研究进一步验证这些发现。