Treatment of adult rhabdomyosarcoma

Am J Clin Oncol. 2010 Apr;33(2):128-31. doi: 10.1097/COC.0b013e3181979222.


Objectives: Rhabdomyosarcoma is an exceedingly rare tumor in adults, and standard chemotherapy used for children is much less effective in adults. This study examines short-term outcomes using doxorubicin, ifosfamide, and vincristine for adult rhabdomyosarcoma.

Methods: Pathology records were searched for adults (age, >18) with rhabdomyosarcoma treated at our musculoskeletal tumor center. Treatment involved surgical resection, radiation therapy, and chemotherapy with doxorubicin, ifosfamide, and vincristine. Eleven met inclusion criteria. Mean age was 49 (range: 19-72). Tumors sites included upper extremity (4 patients), lower extremity (6), and cervix (1). Subtypes were pleomorphic (7), alveolar (1), embryonal (1), and mixed alveolar/embryonal (2).

Results: Of the 7 patients with nonmetastatic disease, 6 had no evidence of disease posttreatment, but 1 died of myelodysplastic syndrome after 51 months. Three patients who received neoadjuvant chemotherapy had 100% tumor necrosis. One patient with positive margins scheduled for adjuvant chemotherapy had local recurrence and metastasis within 2 weeks and died 5 months later. Of the 4 patients with metastatic disease on presentation, 1 had complete response, 2 had partial response with later progression and death at 8 and 24 months, and 1 had immediate progression and died at 12 months. Mean overall survival was 24 months with 6 of 11 (55%) alive at last follow-up. Mean disease-free survival was 17 months for all patients and 23 months for the 7 patients who had remission of all disease.

Conclusions: When combined with surgery and radiation therapy, chemotherapy using doxorubicin, ifosfamide, and vincristine yielded 55% overall and 64% disease-free survival at 2 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Doxorubicin / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Ifosfamide / administration & dosage
  • Male
  • Middle Aged
  • Radiotherapy Dosage
  • Rhabdomyosarcoma / drug therapy
  • Rhabdomyosarcoma / radiotherapy
  • Rhabdomyosarcoma / surgery
  • Rhabdomyosarcoma / therapy*
  • Survival Rate
  • Treatment Outcome
  • Vincristine / administration & dosage
  • Young Adult


  • Vincristine
  • Doxorubicin
  • Ifosfamide