Treatment Options for Childhood Rhabdomyosarcoma
Rhabdomyosarcoma of the bladder and prostate
- For tumors that are only at the top of the bladder: Surgery (wide local excision) is done.
- For tumors of the prostate or other parts of the bladder: Chemotherapy and radiation therapy are given first to shrink the tumor. A biopsy is done and if cancercells remain, surgery to remove the tumor is done. Surgery may include removal of the prostate, part of the bladder, or pelvic exenteration without removal of the rectum. (This may include removal of the lower colon and bladder. In girls, the cervix, vagina, ovaries, and nearby lymph nodes may be removed).
Rhabdomyosarcoma of the vagina, vulva, or uterus
- Rhabdomyosarcoma of the vagina and vulva is usually treated with chemotherapy and radiation therapy.
- Rhabdomyosarcoma of the uterus is usually treated with chemotherapy and radiation therapy. Sometimes surgery may be needed to remove any remaining cancercells.
Rhabdomyosarcoma in unusual areas
- For tumors of the brain: Surgery to remove the tumor followed by radiation therapy and chemotherapy.
- For tumors of the larynx (voice box): A biopsy of the tumor is followed by chemotherapy and radiation therapy. Surgery is usually not done, so that the voice is not harmed.
- For tumors of the diaphragm: A biopsy of the tumor is followed by chemotherapy to shrink the tumor. Surgery may be done later to remove any remaining cancercells.
- For tumors of the kidney: Surgery is done to remove as much of the tumor as is safely possible.
- For tumors of the ovary: Combination chemotherapy may be followed by surgery to remove the remaining tumor.
- Metastaticrhabdomyosarcoma is not usually treated with surgery other than a biopsy for diagnosis. However, if the cancer has spread to the lungs, chemotherapy and radiation therapy are given to shrink the tumor, followed by surgery to remove any remaining cancer cells in the lung.
Every child treated for rhabdomyosarcoma should receive chemotherapy. The dose of the chemotherapy and the number of treatments given depend on the child's risk group, as follows:
- Combination chemotherapy, with or without radiation therapy.
- A clinical trial of different doses and schedules of combination chemotherapy, with or without radiation therapy.
- Combination chemotherapy.
- A clinical trial of combination chemotherapy with radiation therapy.
- Combination chemotherapy.
- A clinical trial of new combinations of anticancer drugs, with and without targeted therapy (monoclonal antibody).
- A clinical trial of immunotherapy.
Radiation therapy options
Radiation therapy may be used if childhood rhabdomyosarcomatumorcells remain after surgery, after chemotherapy, or if the tumor is of the alveolar type.
Treatment may include certain kinds of radiation therapy that cause less damage to normal tissue and lessen late effects of treatment. These include:
- Conformal radiation therapy.
- Intensity-modulated radiation therapy.
- Fractionatedstereotactic radiation therapy.
- Proton-beam therapy.
- A clinical trial of brachytherapy (internal radiation therapy) for cancer in areas such as the vagina, vulva, bladder, prostate, head, or neck.
- A clinical trial of second-look surgery after chemotherapy is given to decrease the amount of radiation therapy that will be needed.