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Timing of RT
Source: Childhood Rhabdomyosarcoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 11, 2025 · Captured 2026-09-09.
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Context: Treatment of Childhood Rhabdomyosarcoma / RT (Local Control Management) / External-beam RT (EBRT)
The timing of RT generally allows for chemotherapy to be given for up to 3 months before RT is initiated. RT is usually administered over 5 to 6 weeks (e.g., 1.8 Gy once per day, 5 days per week), during which time chemotherapy is usually modified to avoid the radiosensitizing agents dactinomycin, doxorubicin, and temsirolimus. Another consideration is the administration of RT before a planned second surgical excision that will be R0 or R1, particularly if RT might facilitate surgical resection to decrease the chances of loss of form or function. This approach is protocol dependent.
The randomized IRS-IV trial reported that the administration of RT twice a day, using 6-hour interfractional intervals at 1.1 Gy per fraction (hyperfractionated schedule), 5 days per week, was feasible, did not improve local control, and was associated with increased acute toxicity.[38] The 5-year local control rate was 87% for all patients on this study.
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For metastatic sites, RT is usually given after 16 to 20 weeks of chemotherapy or, rarely, as consolidation at the completion of planned chemotherapy.
Thus, conventional RT remains the standard for treating patients who have rhabdomyosarcoma with gross residual disease.[39]
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Preserved source evidence · Not medical advice