Cell Biochemistry and Biophysics

, Volume 70, Issue 1, pp 103–108 | Cite as

A Prospective Evaluation of the Combined Helical Tomotherapy and Chemotherapy in Pediatric Patients with Unresectable Rhabdomyosarcoma of the Temporal Bone

  • Xinxin Zhang
  • Kun Ma
  • Jaling Wang
  • Wenming Wu
  • Lin Ma
  • Deliang Huang
Original Paper


We determined the efficacy of combined helical tomotherapy (HT) and chemotherapy in primary/recurrent unresectable rhabdomyosarcoma (RMS) of temporal bone. For this purpose, 9 patients (7 males/2 females), aged 4–9 (average: 6.89) years, with unresectable embryonal RMS of the temporal bone were treated at our hospital. The tumors had either invaded the carotid artery in the cavernous sinus (7/9) or both the cavernous sinus and the skull base foramen (2/9); 7 patients had primary and 2 had recurrent RMS. All patients underwent 2 cycles of induction chemotherapy with VIE (vincristine, ifosfamide, and etoposide), followed by concurrent HT (50–70 Gy) and chemotherapy with VE (vincristine and etoposide for 2 cycles), and 11 cycles of adjuvant chemotherapy with VIE. As a result, all patients achieved complete response, and the 2-year tumor-free survival rate was 100 %. During a follow-up of 3–51 months, all 9 patients were alive. We, therefore, conclude that the induction chemotherapy, adjuvant chemotherapy with VIE and concurrent HT and chemotherapy with VE regimen is effective in treating unresectable embryonal RMS of the temporal bone. The combined modality treatment may achieve the best chance of cure for these patients, thereby changing the therapeutic strategy from palliative to possibly curative.


Rhabdomyosarcoma of temporal bone Unresectable Helical tomotherapy Chemotherapy with VIE 



This work was supported by grants from National Natural Science Foundation (81072195) and Beijing Municipal Science & Technology Commission (Z121107001012042).

Conflict of interest

The authors have declared no conflict of interest.


  1. 1.
    Kuhel, W. I., Hume, C. R., & Selesnick, S. H. (1996). Cancer of the external auditory canal and temporal bone. Otolaryngologic Clinics of Noth America, 29, 827–852.Google Scholar
  2. 2.
    Evans, R. W. (1966). Histological appearance of tumors (2nd ed., p. 56). Edinburgh: Livingstone.Google Scholar
  3. 3.
    Willis, R. A. (1967). Pathology of tumours (4th ed., p. 758). London: Butterworth.Google Scholar
  4. 4.
    Russell, D. S., & Rubebstein, L. J. (1959). The pathology of tumours of the nervous system (p. 215). London: Arnold.Google Scholar
  5. 5.
    Crist, W. M., Anderson, J. R., Meza, J. L., et al. (2001). Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 19, 3091–3102.PubMedGoogle Scholar
  6. 6.
    Bauman, G., Yartsev, S., Rodrigues, G., et al. (2007). A prospective evaluation of helical tomotherapy. International Journal of Radiation Oncology Biology Physics, 68, 632–641.CrossRefGoogle Scholar
  7. 7.
    Bauman, G., Yartsev, S., Fisher, B., et al. (2007). Simultaneous infield boost with helical tomotherapy for patients with 1 to 3 brain metastases. American Journal of Clinical Oncology, 30, 38–44.PubMedCrossRefGoogle Scholar
  8. 8.
    Zhang, X. X., Ma, L., Wang, J. L., et al. (2011). Management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy and/or molecular targeted therapy. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 46, 505–508.PubMedGoogle Scholar
  9. 9.
    Weber, C. O. (1854). Anatomische Untersuchung einer hypertrophischen Zunge nebst Bemerkungen uber die Neubildung guerguestreifter Muskelfasern. Virchows Archiv, 7, 115–125.CrossRefGoogle Scholar
  10. 10.
    Soderberg, F. (1933). Rhabdomyome epipharynge ayant envahi l’oreille et les meninges. Acta Oto-Laryngologica, 18, 453–459.CrossRefGoogle Scholar
  11. 11.
    Newton, W. A, Jr, Soule, E. H., Hamoudi, A. B., et al. (1988). Histopathology of childhood sarcomas, Intergroup Rhabdomyosarcoma Studies I and II: Clinicopathologic correlation. Journal of Clinical Oncology, 6, 67–75.PubMedGoogle Scholar
  12. 12.
    Sbeity, S., Abella, A., Arcand, P., Quintal, M. C., & Saliba, I. (2007). Temporal bone rhabdomyosarcoma in children. Otorhinolaryngology, 71, 807–814.Google Scholar
  13. 13.
    Viswanatha, B. (2007). Embryonal rhabdomyosarcoma of the temporal bone. Ear, Nose, and Throat Journal, 86(218), 220–222.Google Scholar
  14. 14.
    Abbas, A., & Awan, S. (2005). Rhabdomyosarcoma of the middle ear and mastoid: a case report and review of the literature. Ear Nose Throat Journal, 84, 780, 782, 784.Google Scholar
  15. 15.
    Reid, S. R., Hetzel, T., & Losek, J. (2006). Temporal bone rhabdomyosarcoma presenting as acute peripheral facial nerve paralysis. Pediatric Emergency Care, 22, 743–745.PubMedCrossRefGoogle Scholar
  16. 16.
    Raney, R. B, Jr, Lawrence, W, Jr, Maurer, H. M., et al. (1983). Rhabdomyosarcoma of the ear in childhood. A report from the intergroup rhabdomyosarcoma study I. Cancer, 51, 2356–2361.PubMedCrossRefGoogle Scholar
  17. 17.
    Jaffe, B. F., Fox, J. E., & Batsakis, J. G. (1971). Rhabdomyosarcoma of the middle ear and mastoid. Cancer, 27, 29–37.PubMedCrossRefGoogle Scholar
  18. 18.
    Durve, D. V., Kanegaonkar, R. G., Albert, D., & Levitt, G. (2004). Pediatric rhabdomyosarcoma of the ear and the temporal bone. Clinical Otolaryngology & Allied Sciences, 29, 32–37.CrossRefGoogle Scholar
  19. 19.
    Maurer, H. M., Beltangady, M., Gehan, E. A., et al. (1988). The Intergroup Rhabdomyosarcoma Study-I: A final report. Cancer, 61, 209–220.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Xinxin Zhang
    • 1
  • Kun Ma
    • 1
  • Jaling Wang
    • 1
  • Wenming Wu
    • 1
  • Lin Ma
    • 2
  • Deliang Huang
    • 1
  1. 1.Department of Otolaryngology Head and Neck SurgeryChinese People’s Liberation Army General HospitalBeijingChina
  2. 2.Department of Radiation OncologyChinese People’s Liberation Army General HospitalBeijingChina

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