Gasparini M, Lombardi F, Gianni C, Lovati C, Fossati-Bellani F
Am J Clin Oncol. 1983 Aug;6(4):393-8.
Results achieved in two consecutive series of children with rhabdomyosarcoma (RMSA) of the head and neck area, presenting with meningeal involvement, are compared. The first series consisted of 12 children treated with local radiotherapy and with (mostly) polidrug systemic chemotherapy from 1969 to 1977. The second series consisted of 11 children who, besides local radiotherapy and polichemotherapy, received brain radiotherapy (30 Gy) and intrathecal (I.T.) methotrexate (MTX) as central nervous system (CNS) prophylaxis from 1978 to 1980. In the first group, 50% of patients achieved a complete remission and only one child (8%) is surviving relapse-free. In the second group, 91% of patients achieved a complete remission and seven (64%) are surviving relapse-free after a median follow-up of 32 months. The most important reason for failure in the first series was represented by the inability to achieve a persistent local control of the primary tumor. This observation and the higher doses of radiotherapy delivered to the primary tumor in the second series prevent the conclusion that the improved results are attributable entirely to the addition of CNS prophylaxis.
对两组连续的头颈部横纹肌肉瘤（RMSA）患儿的治疗结果进行了比较，这两组患儿均伴有脑膜受累。第一组由12名儿童组成，他们在1969年至1977年期间接受了局部放疗以及（主要是）多种药物联合的全身化疗。第二组由11名儿童组成，在1978年至1980年期间，除了接受局部放疗和联合化疗外，他们还接受了脑部放疗（30 Gy）以及鞘内注射甲氨蝶呤（MTX）作为中枢神经系统（CNS）预防措施。在第一组中，50%的患者实现了完全缓解，只有一名儿童（8%）无复发生存。在第二组中，91%的患者实现了完全缓解，在中位随访32个月后，有7名（64%）患者无复发生存。第一组治疗失败的最重要原因是无法对原发肿瘤实现持续的局部控制。这一观察结果以及第二组中对原发肿瘤给予的更高剂量放疗，使得我们不能得出改善的结果完全归因于增加了中枢神经系统预防措施这一结论。
