How would you approach an adult patient >50 years old with an intermediate risk extremity T2N0 fusion neg rhabdomyosarcoma who is progressing on neoadjuvant chemotherapy with VAC?
How would you add radiation in your treatment paradigm? No clinical trials available due to age.
Answer from: Medical Oncologist at Academic Institution
For patients with primary progression of RMS on VAC chemotherapy, the prognosis is quite poor. I would stop chemotherapy as there is no clear evidence that second line salvage chemo such as vincas, temodar, etoposide, or ifosfamide really improves outcomes. If disease is still localized, radiation i...
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Answer from: Radiation Oncologist at Academic Institution
In the event of disease progression on chemotherapy, it would be advisable to re-examine the pathology of the patient to determine whether the patient has pleomorphic rhabdomyosarcoma, which is a subtype of adult rhabdomyosarcoma. If this is the case, treatment should follow the NCCN guideline for h...