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Local control of parameningeal rhabdomyosarcoma: An expert consensus guideline from the International Soft Tissue Sarcoma Consortium (INSTRuCT)
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  • Dana Casey,
  • Henry Mandeville,
  • Julie Bradley,
  • Simone ter Horst,
  • Anthony Sheyn,
  • Beate Timmermann,
  • Suzanne Wolden
Dana Casey
University of North Carolina at Chapel Hill School of Medicine

Corresponding Author:[email protected]

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Henry Mandeville
The Royal Marsden NHS Foundation Trust
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Julie Bradley
U. Florida Proton Center
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Simone ter Horst
University Medical Center Utrecht, Princess Máxima Center for Pediatric Oncology
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Anthony Sheyn
University of Tennessee Health Science Center
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Beate Timmermann
Westdeutsches Protonenthearpiezentrum
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Suzanne Wolden
Memorial Sloan Kettering Cancer Center
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The International Soft-Tissue Sarcoma Database Consortium (INSTRuCT) consists of a collaboration between the Children’s Oncology Group (COG) Soft Tissue Sarcoma Committee, the European pediatric Soft-Tissue Sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS). As part of the larger initiative of INSTRuCT to provide consensus expert opinions for clinical treatment of pediatric soft tissue sarcoma, we sought to provide updated, evidenced-based consensus guidelines for local treatment of parameningeal rhabdomyosarcoma using both existing literature as well as recommendations from the relevant cooperative group clinical trials. Overall, parameningeal rhabdomyosarcoma represents a distinctly challenging disease to treat given its location near many critical structures in the head and neck, frequently advanced local presentation, and predilection for local failure. Definitive chemoradiation remains the standard treatment approach for parameningeal rhabdomyosarcoma, with surgery often limited to biopsy or salvage therapy for recurrent disease. In this consensus paper, we specifically discuss consensus guidelines and evidence for definitive local management with radiotherapy, with a focus on imaging for radiotherapy planning, dose and timing of radiation, approach for nodal irradiation, various radiation techniques including proton therapy, and the limited role of surgical resection.
01 Mar 2022Submitted to Pediatric Blood & Cancer
01 Mar 2022Submission Checks Completed
01 Mar 2022Assigned to Editor
04 Mar 2022Reviewer(s) Assigned
18 Mar 2022Review(s) Completed, Editorial Evaluation Pending
19 Mar 2022Editorial Decision: Revise Major
29 Mar 2022Submission Checks Completed
29 Mar 2022Assigned to Editor
29 Mar 20221st Revision Received
30 Mar 2022Reviewer(s) Assigned
05 Apr 2022Review(s) Completed, Editorial Evaluation Pending
05 Apr 2022Editorial Decision: Accept
Jul 2022Published in Pediatric Blood & Cancer volume 69 issue 7. 10.1002/pbc.29751