Childhood tumor

1. Surgical treatment

Rhabdomyosarcoma is usually surgically resectable, including all the muscles where the tumor is located. For embryonal rhabdomyosarcoma, in addition to resection, chemotherapy and radiotherapy should be combined to relieve symptoms. Pleomorphic rhabdomyosarcoma did not respond to chemotherapy or radiotherapy.

Biopsy of the tumor showed that complete surgical resection of rhabdomyosarcoma was effective. Only 10% of patients with rhabdomyosarcoma can be completely removed. Even in patients who have been completely resected, chemotherapy and radiotherapy are necessary because of the high metastases of rhabdomyosarcoma.

At the time of surgery, a biopsy of the lymph nodes in the tumor area is required. Complete surgical removal of rhabdomyosarcoma of the head and neck is done in consultation with an ENT, plastic, maxillofacial, and neurosurgeon. If a complete removal affects the appearance and function of the face, the surgery will be delayed until the course of chemotherapy and radiation is complete. Whether to have a second facial surgery depends on the surgical site and the effect of chemotherapy and radiation.

The basic requirement for surgical resection of rhabdomyosarcoma is biopsy. The form of the biopsy is based on medical imaging results, the location and size of the tumor, the patient's age and health, and the doctor's experience. The purpose of removing the tumor completely at the time of surgery is to avoid a second operation.

2. Chemotherapy

When rhabdomyosarcoma cannot be completely resected, patients must undergo chemotherapy. Chemotherapy can completely destroy the remaining tumor. Even if the tumor appears to have been completely removed, chemotherapy is still necessary.

There are many cytotoxic chemotherapeutic drugs, most of which are administered intravenously. The main drugs used for completely resectable embryonal rhabdomyosarcoma are vincristine and remycin. Cyclophosphamide is also commonly used for class II and class III tumors.

Isocyclophosphamide can kill rhabdomyosarcoma cells and is expected to improve the survival rate of class IV patients. Chemotherapy drugs can also kill some normal cells, which can cause side effects. Side effects include hair loss, nausea, vomiting, loss of appetite, fatigue, anemia, and susceptibility to infections. Most side effects disappear when the drug is stopped, and some drugs can permanently damage cells in the ovaries and testes, making it difficult or even impossible to have children. Cyclophosphamide or ifosfamide damage to the kidneys and bladder is also permanent.

3. Radiation therapy

For rhabdomyosarcoma, radiotherapy is a very effective means, can be used as an adjunct to surgical treatment, according to age and site selection of radiation dose, radiation field should include the tumor bed and the surrounding 2 ~ 5 cm of normal tissue, the effective radiation dose is not less than 40Gy.

4. Magnetic induction therapy

Magnetic induction therapy is the use of ferromagnetic materials under the principle of alternating magnetic field heat production, so that the tumor tissue temperature to the effective temperature, so as to achieve the purpose of treatment. Magnetic induction therapy has the characteristics of targeting, conformal, self-controlled temperature, internal heating, repeatability, large temperature difference between normal tissue and tumor, etc. It is expected to overcome the shortcomings of the previous local tumor hyperthermia therapy and become a new effective means to treat tumor.