Patterns of failure following proton beam therapy for head and neck rhabdomyosarcoma

Abstract Purpose Pediatric patients with rhabdomyosarcoma (RMS) of the head and neck (HN all included a component of central nervous system relapse, with leptomeningeal disease and/or LF with an intracranial component. Delayed RT delivery after week 4 of ChT predicted increased risk of relapse for ICE patients (HR 10.49, p  = 0.006). Conclusions PBT confers excellent LC, and a favorable late toxicity profile as compared with prior photon RT data. Our observations support ongoing trial efforts to dose-escalate RT for patients with larger tumors. However, these data raise concerns regarding excess failures among patients with ICE.