Local Control for Pediatric Rhabdomyosarcoma of the Extremities: Is Radiotherapy Always Required After Adequate Surgical Resection? A CanSaRCC Study

jpedsurg.org

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and young adults. Typically, treatment involves a multimodal approach, with radiotherapy (RT) being a standard choice alongside surgical resection for local control, particularly in cases harboring fusions involving FOXO1. However, the long-term consequences of offering RT especially to the extremity in children can be significant including growth delay, contracture, arthritis, and secondary malignancy. Herein, we report the outcome of 10 consecutive patients with extremity RMS from two high-volume institutions who did not receive RT to primary site.

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Article · Jan 2025 · 1 min read

In brief

This study examines whether radiotherapy can be safely omitted after adequate surgical resection in pediatric extremity rhabdomyosarcoma, challenging standard multimodal protocols. The research addresses critical concerns about long-term RT complications in growing children, including growth delay and secondary malignancies.

Radiotherapy may be omitted after adequate surgical resection in select pediatric extremity rhabdomyosarcoma cases.
RT to extremities in children causes growth delay, contracture, arthritis, and secondary malignancy risk.
FOXO1-fusion status typically indicates need for RT, but surgical adequacy may modify this requirement.
Multi-institutional data from 10 patients supports feasibility of RT-sparing approach in extremity RMS.
Local control strategies should balance oncologic outcomes with long-term functional morbidity in pediatric patients.

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