Extended combination therapy of childhood rhabdomyosarcoma

Nineteen children with biopsy-proven rhabdomyosarcoma were selected for a 1-2-year study utilizing surgery, supervoltage, and electron-beam radiation therapy, and combination chemotherapy with vincristine, cyclophosphamide, and dactinomycin. At the time of diagnosis, 4 patients had localized tumor, 9 had regional spread of tumor, 5 had extensive spread of tumor, and 1 had bone marrow involvement. Complete response to therapy was seen in 17 patients, 2 had partial response followed by progressive disease, and 4 died with disease at 15, 11, 8, and 6 months respectively. Eleven patients were free of disease for 4-49 months; 2 had extension of disease at 2 and 4 months. Two patients were just entered on the study and response data is being investigated currently. This approach of extended combination therapy of childhood rhabdomyosarcoma was well tolerated and offers an alternative to radical surgery in the growing child.