How do you manage an adult primary rhabdomyosarcoma of the lung/mediastinum?

Is there any role for consolidative RT/CRT to the lung and mediastinum after initial chemo? What dose and fractionation would be most appropriate for consolidative RT? Would you consider whole lung irradiation?

1 Answer

Mednet MemberInvited Expert

Radiation Oncology · University of Nebraska Medical Center

Answered on

COG trials include all patients <50 years old. The 5-year OS of patients treated in the most recent COG trials is over 70%. So, I would recommend you treat the adult patients per COG protocols if you do not enroll your patients in the COG trials.

To manage rhabdomyosarcoma, we need to know the risk stratification since the treatment regimens are different depending on the risk (Low, intermediate, and high).

To perform risk stratification, we need to know the patient's staging, grouping and histologic type.

Only certain low-risk patients will not need RT. Most patients will need RT. The RT dose and timing depend on the risk stratification.

Where is the exact site of the primary: chest wall? intrathoracic tumor? Mediastinal lymph nodes? lung ...

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