Pediatric rhabdomyosarcoma of the head and neck.

The optimal treatment for most patients with pediatric rhabdomyosarcoma (RMS) of the head and neck has been shown to be a combination of surgery, chemotherapy and radiation therapy. A retrospective review of patients seen at our institution is presented to analyze the impact of multimodality treatment on survival in 32 pediatric RMS patients. Sixty-five percent (21/32) of the patients were disease free at the most recent follow-up. The 5 year disease free survival was 57% (17/30). Combined modality treatment in 25 patients consisting of chemotherapy, radiation therapy and surgical resection (in 5 patients) rendered 18 (72%) patients free of disease. Only 1 of 7 (14%) patients who underwent surgery alone as primary management was cured. Two of these 7 patients were salvaged, both with combined modality treatment. The Intergroup Rhabdomyosarcoma Study (IRS) protocols have resulted in increased survival in pediatric patients with RMS of the head and neck. Our results reflect the significant improvement since the IRS study was completed.