Is there a benefit to metastatic & primary site RT in RMS w/ persistent marrow disease?

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...

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...