Multidisciplinary treatment of primary orbital rhabdomyosarcoma: a single-institution experience

Article Abstract:

Overall, rhabdomyosarcomas are not common, but they are among the most frequent tumors of muscle tissue. Among children, rhabdomyosarcomas account for four to eight percent of cancers. While many rhabdomyosarcomas have a poor prognosis, patients enjoy a far better prognosis if the disease is limited to the eye socket, or orbit. Published studies indicate a two-year survival rate of about 90 percent. In a retrospective evaluation of the treatment of 12 children, the authors indicate that the current treatment method, which combines radiotherapy with chemotherapy, can be completely effective when properly applied. Ten of the 12 patients were immediately treated with radiation and combined chemotherapy upon diagnosis, and two patients were treated with radiotherapy upon recurrence. The authors view the treatment of these two patients as corrective, in that the initial treatment was not properly applied. All 12 patients are alive without evidence of disease at follow-up periods ranging from 7 to 123 months. Eleven of the 12 patients received a radiation dose of 6,000 cGy (a Gy, or Gary, is one Joule of energy absorbed per kilogram of tissue). This level of radiation, when administered to the eye, is believed to cause cataracts. In the present series of patients, cataract formation was observed in only one patient, and lens opacities occurred in another two. An additional eight patients retain good visual acuity; the remaining patient had almost total lack of vision prior to treatment. The excellent preservation of vision is attributed to immediate treatment with radiotherapy. The ability of the eye to recover from radiation exposure may be compromised if radiotherapy is delayed until after chemotherapy. Therefore, treatment should not be delayed once a diagnosis of rhabdomyosarcoma of the orbit is confirmed. The authors suggest that the currently available treatment methods are already optimal and require only proper administration. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Cancer in children, Childhood cancer, Rhabdomyosarcoma, Chemotherapy, Combination, Combination chemotherapy, Eye cancer

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Ewing's sarcoma metastatic at diagnosis: results and comparisons of two intergroup Ewing's sarcoma studies

Article Abstract:

Ewing's sarcoma is a cancer that arises in bone, but the cells within bone that give rise to this tumor have not been determined. The overall survival of Ewing's sarcoma is not good, and most patients die of metastatic disease; a preponderance of patients with Ewing's sarcoma are males. In a review of two studies of Ewing's sarcoma, it was found that vincristine and doxorubicin induced a response in 73 percent of the patients with metastatic disease at the time of presentation; the addition of 5-fluorouracil resulted in a 70 percent response rate, which was not significantly different. About 30 percent of the patients were alive at the end of five years. The most important prognostic indicator was found to be the age of the patient at the time of presentation. Patients under the age of 10 had a significantly better prognosis than older patients. While the reason for this is uncertain, it may be related to the fact that the younger patients were more likely to have disease in rib bone, which is a more favorable site for treatment. The effective chemotherapeutic program is quite toxic, and six to seven percent of the patients died of infectious complications of their chemotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Demographic aspects, Drug therapy, Ewing's sarcoma

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