Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma

Chargari, Cyrus; Haie-Méder, Christine; Guérin, Florent; Minard‐Colin, Véronique; Lambert, Guénolée de; Mazeron, R.; Escande, Alexandre; Marsolat, Fanny; Dumas, Isabelle; Deutsch, Éric; Valteau‐Couanet, Dominique; Audry, G.; Oberlin, Odile; Martelli, Hélène

doi:10.1016/j.ijrobp.2017.02.026

Cited by 53 publications

(92 citation statements)

References 23 publications

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“…Therefore, it is very important to keep irradiated volumes as low as possible to minimize the risk of second cancers and, in this context, brachytherapy has been proposed with high efficacy and acceptable morbidity by expert teams in pediatric patients as part of a multimodal conservative strategy for children with bladder and/or prostate rhabdomyosarcoma. This approach, combining open surgery and catheter placement in the same procedure, requires a close collaboration between surgeons and brachytherapists . A strategy combining brachytherapy and an ovarian transposition also has been proposed in young girls with gynecological malignancies and has produced very high local control rates (Fig.…”

Section: Brachytherapy In the Global Oncological Landscapementioning

confidence: 99%

Brachytherapy: An overview for clinicians

Chargari

Deutsch

Blanchard

et al. 2019

CA A Cancer J Clinicians

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210

125

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Brachytherapy is a specific form of radiotherapy consisting of the precise placement of radioactive sources directly into or next to the tumor. This technique is indicated for patients affected by various types of cancers. It is an optimal tool for delivering very high doses to the tumor focally while minimizing the probability of normal tissue complications. Physicians from a wide range of specialties may be involved in either the referral to or the placement of brachytherapy. Many patients require brachytherapy as either primary treatment or as part of their oncologic care. On the basis of high-level evidence from randomized controlled trials, brachytherapy is mainly indicated: 1) as standard in combination with chemoradiation in patients with locally advanced cervical cancer; 2) in surgically treated patients with uterine endometrial cancer for decreasing the risk of vaginal vault recurrence; 3) in patients with high-risk prostate cancer to perform dose escalation and improve progression-free survival; and 4) in patients with breast cancer as adjuvant, accelerated partial breast irradiation or to boost the tumor bed. In this review, the authors discuss the clinical relevance of brachytherapy with a focus on indications, levels of evidence, and results in the overall context of radiation use for patients with cancer.

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Section: Brachytherapy In the Global Oncological Landscapementioning

confidence: 99%

Brachytherapy: An overview for clinicians

Chargari

Deutsch

Blanchard

et al. 2019

CA A Cancer J Clinicians

Self Cite

210

125

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show abstract

“…Outcome for bladder/ prostate primary was comparable to published results, probably more mutilating surgeries were performed without concomitant radiotherapy. 24 Relation of local control modality on outcome was not assessed for other variables, such as tumor site and size, nodal or metastatic disease and is thus of limited value.…”

Section: Discussionmentioning

confidence: 99%

Treatment of rhabdomyosarcoma in children and adolescent from four low health expenditures average rates countries

Cesen

Bonevski

Mikesková

et al. 2020

Radiology and Oncology

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BackgroundSurvival of children with cancer in Eastern and Central Europe is 10–20% lower than in high income European countries. We evaluated outcome of children and adolescents with rhabdomyosarcoma (RMS) in Slovenia, Croatia, Slovakia and in Romania.Patients and methodsWe retrospectively analysed event-free survival (EFS) and overall survival (OS) for all patients treated in Slovenia and Croatia. Slovakia included patients from two centers, representing half of expected cases. Romania included patients from single institution, representing only 10% of expected patients. Joint database for analysis was established.ResultsOne hundred seventy-eight children and adolescent with RMS diagnosed from January 2000 to December 2015 were included. Mean patient age at diagnosis was 7.7 years, one third was older than 10 years. Twenty-five percent had alveolar histology and 72% unfavorable location. Higher than expected proportion of patients had nodal involvement (24%) or metastatic disease (27%). All patients received systemic chemotherapy, 57% had radiotherapy and 63% surgery as local control. Kaplan- Meier estimates for 5-year EFS and OS were 50.7% and 59.6%, respectively. Five-year OS for patients with localised disease was 72% compared to 24% for metastatic disease.ConclusionsChildren with RMS treated in Eastern and Central Europe have inferior outcome compared to their counterparts treated in high income European countries. Active participation of low health expenditures average rates (LHEAR) countries in international clinical trials may improve outcome of paediatric oncology patients.

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“…Successful management of anal and distal rectal cancer with brachytherapy with or without conservative surgery has already been reported [13]. In RMS of bladder /prostate and vulva/vagina considerable results have been achieved of conservative surgery combined with brachytherapy [14,15].…”

Section: Discussionmentioning

confidence: 99%

Combined management of perianal rhabdomyosarcoma with chemotherapy, radical surgery, and irradiation: A series of three consecutive children

Koivusalo

Rintala

Pakarinen

2019

Journal of Pediatric Surgery

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Background and aim: We describe a series of three successive patients with perianal rhabdomyosarcoma (PRMS) from 2014 to 2017 managed with combined chemotherapy, radical surgery, and radiotherapy. Methods: Ethical consent was obtained. Data including tumor presentation, treatment, and survival was collected from hospital reports. Results: Two girls aged 15 and 16 years (patient #1 and #2) and one boy aged five years (patient #3) were referred because of a suspected perianal abscess. MRI showed large perianal tumors from 7 to 12 cm in diameter that surrounded or infiltrated the anal sphincters and were inconsistent with abscess. Tumor biopsies showed RMS of alveolar (#1 and #2) and embryonal (#3) types. Patient #1 had lymph node and bone metastases, patient #2 lymph node metastases, and patient #3 no metastases. Pretreatment staging, IRS Clinical Group, and Risk Groups were: Stage 4, II, high; Stage 3, GII, intermediate; and Stage 3, I, low, respectively. All underwent colostomy before neoadjuvant chemotherapy (CWS-RMS 2009 program). Neoadjuvant chemotherapy failed to clear the tumors from anal sphincters preventing anus-saving surgery, and all patients underwent abdominoperineal excision. All removed specimens had free margins with negative lymph nodes. After adjuvant chemotherapy and local radiation, the patients were tumor free after 48, 13, and 18 months. Conclusion: In PRMS local surgical control required abdominoperineal excision. Confusion between PRMS and abscess may cause unnecessary delay in management. Level of Evidence: IV (Treatment Study, Case Series with no Comparison Group).

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Brachytherapy Combined With Surgery for Conservative Treatment of Children With Bladder Neck and/or Prostate Rhabdomyosarcoma

Cited by 53 publications

References 23 publications

Brachytherapy: An overview for clinicians

Brachytherapy: An overview for clinicians

Treatment of rhabdomyosarcoma in children and adolescent from four low health expenditures average rates countries

Combined management of perianal rhabdomyosarcoma with chemotherapy, radical surgery, and irradiation: A series of three consecutive children

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