Ethical Analysis as a Tool for Addressing Treatment Controversies: Radiotherapy Timing in Children With Orbital Rhabdomyosarcoma as a Case Example

Farnia, Benjamin; Majumder, Mary A.; Paulino, Arnold C.

doi:10.1016/j.jacr.2014.10.010

Cited by 4 publications

(2 citation statements)

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“…[3-8-14-16-17-18-19-20-21] Since the Intergroup for Rhabdomyosarcoma (IRS) formation, in 1972, several multicentric studies have been conducted and published including orbital RMS. [22,23,24,25] Recently, new radiotherapy techniques have been applied in the treatment of orbital RMS, such as a protons beam, intensity-modulated radiotherapy (IMRT), and volumetric arc (VMAT); these new approaches allow dose reduction in healthy tissues and imply post-treatment toxicities reduction. [14] Despite technological advances, children with orbit rhabdomyosarcoma submitted to multimodal treatment (surgery, chemotherapy and radiotherapy) still present signi cant alterations in teeth and facial bones in development.…”

Section: Introductionmentioning

confidence: 99%

Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

de Mattos,

Ferman,

Magalhães

et al. 2024

Preprint

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Purpose: Orbital rhabdomyosarcoma is a rare soft tissue sarcoma in childhood but with a good prognosis. Treatment usually includes surgery, chemotherapy, and radiotherapy. This study aimed to evaluate long-term alterations in teeth and cranial bones in children, adolescents, and young adults after oncologic treatment for childhood orbital rhabdomyosarcoma. Method: This was a cross-sectional study that evaluated patients treated for orbital rhabdomyosarcoma between 1988 and 2011. Demographic, clinical, and treatment data were collected during the study period; also, panoramic radiographs, cephalometric study, and photographs of the face were taken. Results: Eight long-term survivors were studied. Of those, 50% were male, 75% had less than 5 years of treatment, and 88% had only one of the orbits affected by the tumor. Regarding treatment, 50% received 50.4 Gy of radiotherapy in the orbit; the chemotherapy included vincristine, actinomycin D, and cyclophosphamide in 75% of the cases and also ifosfamide and etoposide in 25%. The children presented craniofacial alterations, mainly when radiotherapy occurred between 0 and 5-year- old. (p=0.01) The mandibles also showed dental alterations, probably due to chemotherapy. Conclusion: In conclusion, orbital RMS patients treated with chemoradiotherapy, important dental and facial bone alterations were found. The most significant were in the maxilla and close to the irradiation field. Dental and mandibular bone alterations were also found, indicating the probable chemotherapy action, as this region was not included in the irradiation field.

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Section: Introductionmentioning

confidence: 99%

Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

de Mattos,

Ferman,

Magalhães

et al. 2024

Preprint

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“…The use of RT in most patients as part of the initial management in the North American approach aims to minimize disease recurrence, whereas the European approach attempts to prevent radiation-induced effects by avoiding the use of upfront RT. 11 In this study, using Surveillance Epidemiology and End Results (SEER) database, 12 we investigated the prognoses and survival outcomes of patients with orbital embryonal rhabdomyosarcoma according to the local treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

The prognosis and effects of local treatment strategies for orbital embryonal rhabdomyosarcoma: a population-based study

Tang

Zhang

et al. 2018

CMAR

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IntroductionOrbital embryonal rhabdomyosarcoma is a rare childhood malignancy with a good prognosis, but the optimal treatment remains unclear. Using a population-based cancer registry, we assessed the prognoses and survival outcomes of patients with orbital embryonal rhabdomyosarcoma according to the local treatment strategy.Patients and methodsPatients diagnosed with orbital embryonal rhabdomyosarcoma between 1988 and 2012 as part of the Surveillance Epidemiology and End Results program were included. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors associated with cause-specific survival (CSS) and overall survival (OS).ResultsIn total, 102 patients were included; their median age was 6 years, 78.4% were white, and 56.9% were male. The median tumor size was 30 mm. Of 20 patients with an available histologic grade, the tumors of 90% were poorly differentiated/undifferentiated. Of 92 patients with available surgical and radiotherapy (RT) statuses, 50 (54.3%), 36 (39.1%), and 6 (6.5%) received surgery and RT, primary RT, and primary surgery, respectively. Ninety-five patients (93.1%) received chemotherapy. The 5- and 10-year CSSs of the entire cohort were 94.3% and 92.2%, respectively. The 5- and 10-year OSs were 93.3% and 91.3%, respectively. In 95 patients who were followed up for at least 12 months, there were no significant prognostic factors related to CSS and OS. Furthermore, the local treatment strategy did not significantly affect CSS (P=0.29) or OS (P=0.468).ConclusionThere is no local treatment of choice for orbital embryonal rhabdomyosarcoma in terms of survival. However, RT is a reasonable alternative treatment to surgery.

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Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

de Mattos,

Ferman,

Magalhães

et al. 2024

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Ethical Analysis as a Tool for Addressing Treatment Controversies: Radiotherapy Timing in Children With Orbital Rhabdomyosarcoma as a Case Example

Cited by 4 publications

References 43 publications

Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

The prognosis and effects of local treatment strategies for orbital embryonal rhabdomyosarcoma: a population-based study

Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

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