Kovács N., Holland D., Kovács G., Maune S., Galalae R., Mehdorn H. M.

Interdisciplinary Brachytherapy Centre, University Hospital, Arnold-Heller Str. 9, D-24105 Kiel

Background: Especially the treatment of recurrent RMS results often in exenteration. This approach, which results also in minor life quality of the patient, can be eliminated by an interdisciplinary treatment schedule containing function preservation surgery, brachytherapy and chemotherapy. The feasibility of this schedule was proven in this study.
Methods: In cooperation of the clinics of Ophthalmology, ORL and Head & Neck Surgery, Neurosurgery and Radiation Therapy we treated between 1993 and 2001 eight children (2 primary- and 6 recurrent RMS) at the mean age of 6 years (14 months - 13 years). The CWS-study centre coordinated the treatment. In 2 cases the parents of the children were not conform to the external beam radiation (EBRT) part of the treatment schedule. In this cases surgery + BT combined with chemotherapy regime was performed. The mean BT dose was 23 Gy in 5 days. The EBRT dose was mean 40 Gy, hyperfractioneted. Mean follow-up is 31,25 months (1-84 months).
Results: Two of 8 patients died on tumour 15 and 17 months after treatment. The other 6 children are living tumourfree, the two cases refusing EBRT live without the late effects of EBRT at this young age. Seven out of 8 patiens showed no differences in visual tests compared to pretreatment status. In one combined EBRT and BT case progredient cataract and retinopathy were observed.
Conclusion: Organ and function preservation by minimal surgery and peroperative interstitial brachytherapy combined with multiagent chemotherapy seems to be a feasible alternative to exenteration and chemotherapy in the case of recurrent intraorbital RMS of the child.

Copyright © Deutsche Ophthalmologische Gesellschaft, 2001. All rights reserved.

Last updated: 

Webdesign: SPALLEK.COM