Naima Smeulders, Florent Guerin, Mark N. Gaze, Timothy Rogers, Sheila Terwisscha van Scheltinga, Federica De Corti, Julia Chisholm, Olga Slater, Veronique Minard-Colin, Beatrice Coppadoro, Ilaria Zanetti, Ross Craigie, Gabriela Guillen Burrieza, Patrizia Dall'Igna, Raquel Davila Fajardo, Pei S. Lim, Cyrus Chargari, Sophie Espenel, Ana L. Luis Huertas, Alexander Cho, Trung Nguyen, Helen Rees, Gianni Bisogno, Hans Merks, Helene Martelli, JC Paediatric Oncology 6 (2025) 100313
https://doi.org/10.1016/j.ejcped.2025.100313
This study looked at children and young people with a rare cancer called bladder-prostate rhabdomyosarcoma that had not spread to lymph nodes or other parts of the body. Researchers compared different ways of treating the tumour locally after chemotherapy.
One approach aimed to preserve the bladder and nearby organs using organ-sparing surgery combined with internal radiotherapy (brachytherapy). Other patients received more extensive surgery that removed organs, external radiotherapy, or combinations of these treatments.
A total of 176 patients were followed for about 6.5 years. Overall outcomes were good: about 80% of patients remained free from disease progression after 5 years, and about 91% were alive at 5 years.
Although patients receiving different treatments had different tumour features, the risk of tumour progression was similar across treatment types. However, survival differed: the best survival was seen in patients treated with surgery alone or with brachytherapy (with or without organ-sparing surgery). Patients treated with external radiotherapy had poorer outcomes if the tumour later returned, as rescue treatment was less successful.
Delaying local treatment until later in chemotherapy did not worsen outcomes.
In summary, when feasible, brachytherapy combined with organ-sparing surgery offers excellent chances of cure while preserving bladder function and avoiding external radiotherapy.
One approach aimed to preserve the bladder and nearby organs using organ-sparing surgery combined with internal radiotherapy (brachytherapy). Other patients received more extensive surgery that removed organs, external radiotherapy, or combinations of these treatments.
A total of 176 patients were followed for about 6.5 years. Overall outcomes were good: about 80% of patients remained free from disease progression after 5 years, and about 91% were alive at 5 years.
Although patients receiving different treatments had different tumour features, the risk of tumour progression was similar across treatment types. However, survival differed: the best survival was seen in patients treated with surgery alone or with brachytherapy (with or without organ-sparing surgery). Patients treated with external radiotherapy had poorer outcomes if the tumour later returned, as rescue treatment was less successful.
Delaying local treatment until later in chemotherapy did not worsen outcomes.
In summary, when feasible, brachytherapy combined with organ-sparing surgery offers excellent chances of cure while preserving bladder function and avoiding external radiotherapy.
