How would you treat a pediatric embryonal rhabdomyosarcoma of the kidney with preoperative rupture s/p nephrectomy and getting VAC/VI chemotherapy?
Would you treat this with whole-abdomen RT with a boost? What dose would you recommend? This would be Stage 1, Group 2 (R1 resection), low risk; but likely should be treated more like a Group 3 (R2 resection), intermediate risk given the preoperative rupture. ARST 0531 recommends using 24 Gy in 1.5 Gy/fx if doing whole abdomen RT, and typical dose for R1 resection is 50.4 Gy, but this would be limited by the bowel.
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · University of Cincinnati College of Medicine
Answered on
This is an uncommon clinical presentation. If there was diffuse abdominal spill, then whole abdominal radiotherapy would be indicated. Though recent COG study guidelines specify 24 Gy whole abdomen radiotherapy dose, that may not be adequate for microscopic tumor. In other tumors (ie, diffuse small ...
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