Five-year follow-up after multimodal treatment incorporating HDR brachytherapy for bladder prostate rhabdomyosarcoma in children
Menée à partir de données 2004-2018 portant sur 10 patients atteints d'un rhabdomyosarcome de la vessie ou de la prostate (durée médiane de suivi : 62 mois), cette étude analyse l'efficacité, du point de vue de la survie, d'un protocole intégrant une curiethérapie à haut débit de dose
Rhabdomyosarcoma is the most common soft-tissue sarcoma in childhood, 15-20 % of cases arising in the genitourinary tract. As survival in bladder-prostate rhabdomyosarcoma (BPRMS) has improved, the focus of treatment has shifted towards organ preservation. Collaborative study groups now recommend neo-adjuvant chemotherapy combined with surgery and external beam radiotherapy (EBRT), to balance the intensity of treatment with the consequences of long-term sequelae. 5-year survival has increased to over 80%, but nevertheless, only 40% of survivors have a normal bladder and sexual function. Radical surgery is detrimental for bladder function, since many tumors are located in an area critical for bladder innervation and long-term sequelae from EBRT in children are also significant. Low-Dose-Rate (LDR) brachytherapy in combination with bladdersparing surgery was established, in an effort to minimize these adverse effects. More recently, Pulsed-Dose-Rate (PDR), and High-Dose-Rate (HDR) brachytherapy, have been reported. The first long term follow-up after LDR brachytherapy for BP-RMS, has shown promising outcomes with regards to kidney function, bladder function and quality of life, but reports on late effects are sparse. We evaluated the results after a median follow up of 5 years after treatment of BP-RMS in children, with a protocol incorporating HDR brachytherapy.
International Journal of Radiation Oncology, Biology, Physics