Abstract：
Approximately one third of children with rhabdomyosarcoma relapse or have refractory disease. Treatment approaches include a combination of systemic therapies and local therapies, directed at tumour site(s). This review was conducted to evaluate the effectiveness and safety of the combination of surgery and brachytherapy as local therapy for treating children and young people with relapsed/refractory rhabdomyosarcoma. This review identified studies based on a previous systematic review looking at the treatments for children and young people under 18 years old with relapsed/refractory rhabdomyosarcoma. Studies conducted after 2000 were included. Survival outcomes, relapse rates, adverse events and functional outcomes were extracted. From 16,965 records identified in the baseline systematic review, 205 included the words \'AMORE\' or \'brachytherapy\', and were screened for eligibility in this substudy. Thirteen studies met the inclusion criteria for Local-REFoRMS, including over 55 relapsed and refractory rhabdomyosarcoma patients. Most studies were retrospective cohort studies conducted within Europe. Most patients had embryonal disease within the head and neck or bladder/prostate regions, and received local therapy for first relapse. Approximately one quarter of patients relapsed following surgery and brachytherapy, with local relapses occurring more than metastatic relapse. Adverse events and functional outcomes were infrequently reported, but related to the site of surgery and brachytherapy. Study quality was limited by inconsistent reporting and potential selection bias. Outcomes following surgery and brachytherapy for a selected group of relapsed and refractory rhabdomyosarcoma show reasonable benefits, but reporting was often unclear and based on small sample sizes.
摘要：
大约三分之一的儿童患有横纹肌肉瘤复发或患有难治性疾病。治疗方法包括全身疗法和局部疗法的结合，针对肿瘤部位。本综述旨在评估手术和近距离放射治疗相结合作为局部治疗儿童和年轻人复发性/难治性横纹肌肉瘤的有效性和安全性。这篇综述基于先前的系统综述，研究了18岁以下儿童和青少年复发性/难治性横纹肌肉瘤的治疗方法。包括2000年后进行的研究。生存结果,复发率,提取不良事件和功能结局.从基线系统审查中确定的16,965条记录中，205包括单词\'AMORE\'或\'近距离放射治疗\'，并在本子研究中筛选合格。13项研究符合Local-REFoRMS的纳入标准，包括超过55例复发和难治性横纹肌肉瘤患者。大多数研究是在欧洲进行的回顾性队列研究。大多数患者在头颈部或膀胱/前列腺区域有胚胎性疾病，并接受局部治疗首次复发。大约四分之一的患者在手术和近距离放射治疗后复发，局部复发的发生多于转移性复发。不良事件和功能结果很少报告，但与手术和近距离放射治疗的部位有关.研究质量受到报告不一致和潜在选择偏倚的限制。手术和近距离放射治疗一组选定的复发性和难治性横纹肌肉瘤后的结果显示出合理的益处。但报告通常不清楚,且基于小样本量.
