Is there a benefit to metastatic & primary site RT in RMS w/ persistent marrow disease?
In a patient with high risk rhabdomyosarcoma with significant marrow involvement (Stage IV), who has responded completely on imaging to all known sites after chemo, would you proceed with planned XRT if re-staging bone marrow biopsy still showed rare malignant cells?
2 Answers
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Radiation Oncology · Stanford University School of Medicine
Answered on
While I agree with the response by Dr Ermoian, I believe the case is more complicated than simply irradiating the gross disease at the primary site. Overall survival and Progression Free Survival for Stage 4, Group IV RMS has not changed substantially over the past almost 5 decades, despite many suc...
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Radiation Oncology · University of Washington Medical Center
Answered on
I would treat the primary site based on it likely having the greatest concentration if not burden of disease. However, if for some reason the patient has had a resection with +microscipic margins, then I would be much more hesitant to do local therapy since the burden of disease in that circumstance...
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