Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Oncology (Clinical)

Study purpose and objectives: To assess local control rate and calculate the overall survival (OS) and progression free survival (PFS) of pediatric PM RMS patients treated at NCI between 2005 and 2014 and to examine the possible prognostic factors affecting treatment outcome. Materials and Methods: A retrospective study in which medical records of 44 patients newly diagnosed with PM RMS treated at NCI between 2005 and 2014 at Radiation Oncology department, National Cancer Institute, Cairo University, were reviewed. The rate of local control was determined as well as the overall survival and the progression free survival. Prognostic factors and their effect on survival were studied. Results: Median age was 7 years (range: 1 to 20 years). Male to female ratio was 1.9:1. The commonest primary subsite was nasopharynx (29.6%) followed by maxilla (20.5%) and infratemporal fossa (18.2%). Embryonal RMS was the most common pathological subtype (63.6%). Intracranial extension (ICE) was reported in 31.8% of cases. IRSG stage 3 constituted 75% of cases. All patients were treated by systemic CTH (VAC) then RTH was adopted at week 0 {u2013} 4 in case of ICE and at week 12 in the absence of this risk factor. Radiotherapy was the local treatment modality in 39 cases and 2 patients underwent surgery followed by radiotherapy postoperatively while 2 patients underwent surgery only and one patient died due to disease progression after receiving induction chemotherapy. Median RTH dose was 5040 cGy and median overall treatment period (OAP) was 47 days. Complete response was reported in 75% of cases. The 5 year OS and PFS rates were 50% and 43.8% respectively. Factors which affected survival included age at diagnosis, T stage, pretreatment Hemoglobin %, ICE, OAP and treatment response at week 40 on univariate analysis while on multivariate analysis only OAP and treatment response affected survival

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