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Amore protocol in pediatric head and neck rhabdomyosarcoma: Descriptive analysis of failure patterns

  1. Joeri Buwalda MD, PhD1,*,
  2. Nicole J. Freling MD, PhD2,
  3. Leo E. C. M. Blank MD3,
  4. Alfons J. M. Balm MD, PhD1,
  5. Johannes Bras MD, PhD4,
  6. Paul A. Voûte MD, PhD5,
  7. Huib N. Caron MD, PhD5,
  8. Paul F. Schouwenburg MD, PhD1,
  9. Johannes H. M. Merks MD, PhD5

Article first published online: 11 APR 2005

DOI: 10.1002/hed.20164

Issue

Head & Neck

Head & Neck

Volume 27, Issue 5, pages 390–396, May 2005

Additional Information

How to Cite

Buwalda, J., Freling, N. J., Blank, L. E. C. M., Balm, A. J. M., Bras, J., Voûte, P. A., Caron, H. N., Schouwenburg, P. F. and Merks, J. H. M. (2005), Amore protocol in pediatric head and neck rhabdomyosarcoma: Descriptive analysis of failure patterns. Head Neck, 27: 390–396. doi: 10.1002/hed.20164

Author Information

  1. 1

    Department of Otorhinolaryngology and Head and Neck Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE Amsterdam, The Netherlands

  2. 2

    Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands

  3. 3

    Department of Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands

  4. 4

    Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands

  5. 5

    Department of Pediatric Oncology, Academic Medical Center, Amsterdam, The Netherlands

*Department of Otorhinolaryngology and Head and Neck Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO box 22700, 1100 DE Amsterdam, The Netherlands

Publication History

  1. Issue published online: 18 APR 2005
  2. Article first published online: 11 APR 2005
  3. Manuscript Accepted: 8 NOV 2004

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Keywords:

  • head and neck neoplasms;
  • rhabdomyosarcoma;
  • combined modality therapy;
  • surgery;
  • brachytherapy

Abstract

Background.

The AMORE protocol is a local treatment for patients with nonorbital pediatric head and neck rhabdomyosarcoma (HNRMS). The objectives of this study were: (1) to assess the adequacy of the concept, and (2) to identify factors associated with relapse.

Methods.

We performed a retrospective multidisciplinary review of 22 children primarily treated according to the AMORE protocol, excluding two children with inadequate imaging data.

Results.

Seven patients had a local relapse, six within and one outside the residual tumor area. Five of the six patients with relapse in the residual area had gross total or debulking (incomplete) surgery, suboptimal position of the mold for brachytherapy, or both. In the 15 nonrecurrent cases, four patients had either incomplete surgery or suboptimal mold position. Both surgical and brachytherapeutic factors seem to be associated with relapse.

Conclusions.

AMORE is an adequate concept. More rigid preoperative imaging and intraoperative verification of the brachytherapy mold position might lead to a reduction in the number of local failures. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005

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