Head and neck rhabdomyosarcoma in children: a 20-year retrospective study at a tertiary referral center

J Cancer Res Clin Oncol. 2018 Feb;144(2):371-379. doi: 10.1007/s00432-017-2544-x. Epub 2017 Nov 16.

Abstract

Objective: The purpose of this study was to assess rhabdomyosarcomas (RMS) of the head and neck in pediatric patients with regard to clinical presentation, treatment, and survival.

Methods: Data were retrospectively obtained from patient charts with regard to RMS of the head and neck diagnosed between 1996 and 2016 at a tertiary referral center. Clinical course, treatment modalities, and side effects were analyzed. Survival analysis was carried out using the Kaplan-Meier method.

Results: Twenty-eight patients (17 male, 11 female) with a mean age at diagnosis of 6.8 ± 5.0 years have been included. Fourteen patients (50%) presented with painless swelling in the head and neck region and nine patients (32.1%) presented with cranial nerve deficit at initial diagnosis. The location of the majority of rhabdomyosarcomas was orbital (N = 9; 32.1%), followed by parapharyngeal (n = 4; 14.2%) and sinonasal (n = 3; 10.7%). All patients (n = 28; 100%) received polychemotherapy, additional adjuvant radiation therapy was carried out in 24 patients (85.7%), and surgery was performed in 12 cases (42.9%). The 5-year overall survival was 91.3%, and median progression-free survival was 46 ± 67.4 months. Common side effects resulting from chemotherapy and radiation therapy included neutropenia, mucositis, nausea and vomiting, and radiodermatitis, long-term side effects included microsomia and facial mutilation.

Conclusion: Multimodality treatment of rhabdomyosarcomas of the head and neck in pediatric patients may lead to a 5-year overall survival of up to 91.3%.

Keywords: Alveolar; Embryonal; Head and neck; Rhabdomyosarcoma.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Chemoradiotherapy
  • Child
  • Cytoreduction Surgical Procedures
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Retrospective Studies
  • Rhabdomyosarcoma / pathology*
  • Rhabdomyosarcoma / therapy*
  • Tertiary Care Centers