Soft-tissue sarcomas of the head and neck in children (original) (raw)
Related papers
International Journal of Radiation Oncology*Biology*Physics, 1995
and 51nstitute of Biophysics arid Radiobiology, University of Hamburg, Germauy Purpose: To analyze our experience treating soft tissue sarcomas of the head and neck in adults, and to -patterns of failure and prognostic factors. Methods and Materials: The records of 57 patients with Stage MO disease treated by radiation with or without surgery between 1972 and 1993 were reviewed. Median foiiow-up time was 4.3 years (range, l.l-16.8 years). A group of potentiai prognostic factors was evaluated, inchulmg age at diagnosis, sex, initiai tumor presentation (p&nary vs. recurrent), grade, T-stage, direct tumor extension, tumor depth, duration of treatment, and radlatlon dose. Results: The subset of angiosarcomas (11 out of 57 patients) had a considerably adverse effect on treatment outcome for the total group of sarcomas, with actuariai 5-year overali survivai (OS), locoregional control (LRC), and freedom from distant metastasis (FDM) rates being 31%, 24%, and 42%, respectively. In contrast, for the remaining 46 patients with other histopathologicai tumor types, OS, LRC, and FDM rates were signliicantly higher (74 % ,69 % , and 83 % , respectively). For this group of patients, significant prognostic factors identllied by uni-and multivarlate analysis included tumor grade as a predictor of OS and Tstage as a predictor of LRC (p 5 0.050). Those patients who experienced a locoregional recurrence were at a signilicantly increased risk of dying (p = 0.004 in a multivariate model). All 17 patients without direct tumor extension to neurovascular structures, bone, contiguous organs, or skin remained free from distant failure. In contrast, 27% of 29 patients with dhect extension had develop& distant metastases at 5 years.
Management and prognosis of head and neck sarcomas
American Journal of Surgery, 1989
Between 1962 and 1988, a total of 104 Patients with head and neck rhabdomyosarco ma @MS) and 17 patients with nonrhabdomyosareoma (NRMS) were evaluated and treated at St. Jude Children's R esearcb Hospital. All parameningeal sites (middle ear, orbit, or nasopharynx) were excluded from further analysis; thus, 50 patients represent the cohort of head and neck sarcomas for this review. Survival was good in this group of patients, 28 of 50 being alive and disease-free at last follow-up. Twenty of the 38 patients with RMS were alive and disease-free. Similarly, 8 of the 12 patients with NRMS were disease-free at a median follow-up of 5 years. However, the site and size of the primary tumor impacted on the extent of the initial re.section and further treatment in addition to surgery. Although the treatment policy evolved over time to a stage-specific strategy for treatment modalities, the data suggest that surgery alone may bc sufficient initial therapy for a subset of patients. For patients in whom complete resection is not achieved, the addition of radiotherapy and chemotherapy may result in improved survival.
European Journal of Cancer, 2007
To evaluate the local control rates and survival rates of patients with Group III parameningeal rhabdomyosarcoma (PM-RMS) treated with a dose intensive chemotherapy regimen followed by irradiation. Materials and methods: Twenty-six patients with group III, PM-RMS were enrolled in a prospective pilot trial at the Mayo Clinic, Rochester, MN and Children's Hospital and Regional Medical Center Seattle, WA. The median age at diagnosis was 8.5 years (range 1.5-19 years). The male to female patient ratio was 1.6:1. Twenty-three patients had embryonal histology with the remaining three alveolar. Risk factors indicating high risk disease included intracranial extension (10 patients), base of skull erosion (12 patients), and cranial nerve palsy (10 patients). The median follow-up period for all patients was 82 months (range 17-148 months). Patients were treated with an intensified chemotherapy regimen followed by definitive local irradiation at week 12 following further chemotherapy. The median time from initiation of chemotherapy to irradiation was 16 weeks (range 6-23). The median dose delivered was 50.4 Gy (50.4-66.6 Gy). Results: Response was assessed after the fourth course of chemotherapy. Three patients exhibited a complete response, 22 a partial response, and 1 patient had no response after two cycles of chemotherapy and proceeded to irradiation at week 6. The 5-year estimated event free survival was 81% (±15%, 95% CI). Two patients died from progressive metastatic disease; 1 patient died from secondary malignancy; and 2 patients died from locally progressive disease. The 5-year local control rate was 92% (±10.6%, 95% CI). Conclusions: Treatment of group III PM-RMS patients with neo-adjuvant, intensive chemotherapy with a delay in irradiation resulted in excellent local-regional control rates and survival rates and may allow for a response-based radiotherapy approach.
Head and neck soft tissue sarcomas treated with radiation therapy
Rare Tumors, 2016
Head and neck soft tissue sarcomas (HNSTSs) are rare and heterogeneous cancers in which radiation therapy (RT) has an important role in local tumor control (LC). The purpose of this study was to evaluate outcomes and patterns of treatment failure in patients with HNSTS treated with RT. A retrospective review was performed of adult patients with HNSTS treated with RT from January 1, 1998, to December 31, 2012. LC, locoregional control (LRC), disease-free survival (DFS), overall survival (OS), and predictors thereof were assessed. Forty-eight patients with HNSTS were evaluated. Five-year Kaplan-Meier estimates of LC, LRC, DFS, and OS were 87, 73, 63, and 83%, respectively. Angiosarcomas were found to be associated with worse LC, LRC, DFS, and OS. Patients over the age of 60 had lower rates of DFS. HNSTSs comprise a diverse group of tumors that can be managed with various treatment regimens involving RT. Angiosarcomas have higher recurrence and mortality rates.
Local-regional non-rhabdomyosarcomatous soft tissue sarcomas of the head and neck
International Journal of Radiation Oncology*Biology*Physics, 1990
Between 1962 and 1987, 112 consecutive patients were treated at St. Jude Children's Research Hospital for soft tissue sarcomas of the head and neck region; 18 of these children (16%) had histologic subtypes other than rhabdomyosarcoma. We evaluated the impact of surgery, postoperative chemotherapy, and irradiation on local control and survival in these cases. Three patients who had complete resection of tumors and received no further treatment are alive without disease at 36,42, and 162 months. Local control was achieved in 1 of 2 patients with microscopic residual tumor and 4 of 9 patients with gross residual tumor who were treated with irradiation (2500-5040 cGy). Chemotherapy was the only postoperative treatment in three patients; only one achieved lasting local control. One patient was treated with irradiation only; his primary site showed no tumor cells at autopsy following an automobile accident. Overall, local control was achieved in 50% of patients; the disease-free survival rate at 3 years was 44%. The prognosis for patients with nonresectable tumors remains unsatisfactory because of the difficulty in securing local control. A revised therapeutic approach to these patients is presented. Head and neck tumors, Sarcoma, Pediatric oncology.
A radiological and radiotherapeutic approach for paediatric tumours in the head and neck area
2013
The most common paediatric malignancies in the head and neck area consisted of lymphoma, leukaemia, brain tumours, neuroblastoma, Wilms’ tumour, sarcomas and primary rhabdomyosarcomas. This review reports in brief radiological diagnosis and staging together with radiation treatment, in terms of common clinical practice. Ultrasound, computerized tomography, magnetic resonance imaging and lately positron emission tomography are playing an important diagnostic role, which is discussed. Further, the radiation treatment represents an important weapon against paediatric neoplasia. In general, the prescribed dose is 35 (1.7 Gy per fraction), 24 (1.6 Gy per fraction) and 54–60 Gy (1.8 Gy per fraction) for lymphoma, leukaemia and central nervous system tumours, respectively. Modern techniques such as intensity modulated radiation therapy and protons, offer tremendous scope, although these are not widely used yet. The main aspect related to irradiation in paediatric tumours in the head and ne...
Recommendations in management of head and neck sarcomas
Oncology in Clinical Practice
Sarcomas of the head and neck are rare malignant tumours with incidence 2% of head and neck cancers, 30% of all sarcomas in children and 4-10% of sarcomas in adults. The most common sarcoma in children is rhabdomyosarcoma (RMS) and Ewing sarcoma (ES), in contrary in elderlies there is angiosarcoma; osteosarcoma and chondrosarcoma are the most common bone tumours in head and neck. The typical symptoms are: painless tumour in the head and neck region, difficulty with speaking, hoarseness, dysphagia, nasal obturation, or dysfunction of cranial nerves. The key point of diagnostics is magnetic resonance and computed tomography of the primary tumour. The treatment of patients with sarcoma should be carried out in referral centers, where experienced multidisciplinary team proceed the surgical removal of a primary tumour with reconstructive surgery as well as perioperative systemic therapy (in selected cases). The recommendations were developed by the Head and Neck Sarcoma Group of the Polish Registry of Bone Tumors.