Would you recommend radiation therapy for an adult patient with rhabdomyosarcoma (embryonal) of the upper extremity s/p amputation with multiple lymph node involvement and ENE on pathology?

Topics: Radiation Oncology • Sarcoma

The patient is in their 40s with right arm rhabdomyosarcoma s/p amputation. Path shows embryonal rhabdomyosarcoma 6.5 cm, margins neg. 11 of 19 lymph nodes were positive with extranodal extension. stage III. FOX01, NCOA2, TFE3: Not detected. Neo genomic results pending.

Answer from: Radiation Oncologist at Academic Institution

Yes, I would treat the involved nodal region. This patient has what appears to be stage III, group 2c intermediate-risk disease. If treating per ARST0531 dose to involved nodal region would be 41.4 Gy in 1.8 Gy per fraction, though with ENE, I would consider escalating that specific area to 50.4 Gy ...

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Radiation Oncologist at Texas Oncology
I got the finalized path report and some sections ...

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