放射肿瘤学家对患有转移性横纹肌肉瘤 (RMS) 的儿童采用不同的放射治疗。对 XXXX 研究的数据进行了回顾性分析，以验证之前的观察结果，即放疗的使用与改善预后相关，并指导未来对该患者组的放疗使用建议。对 216 名年龄在 0-21 岁的转移性 RMS 患者进行了放疗进行回顾性审查并分类为根治性（所有疾病部位均在方案参数内接受照射）、部分（某些部位在方案参数内接受了照射）和无（无放射或在方案参数外进行）。标志性分析排除了第 221 天​​之前发生事件的患者。使用 Kaplan-Meier 方法对总生存期 (OS) 和无进展生存期 (PFS) 进行建模，以研究辐射的影响。使用 Cox 回归模型检查治疗和已知预后因素的联合效应。根据方案，总共 56 名患者接受了根治性治疗，104 名患者接受了部分治疗，56 名患者没有接受放射治疗。由于非随机数据，各组存在异质性，特别是接受根治性放射治疗的患者中，转移性疾病部位较少，骨转移较少。根治性放疗、部分放疗和无放疗的 3 年 PFS 分别为 62.0% (95%CI 47.9-73.4) vs 39.5% (29.8-49.1) vs 30.1% (18.7-42.3)(p=0.002)； 3 年 OS 分别为 70.1% (55.8-80.6) vs 53.1% (42.6-62.5) v 52.3% (38.3-64.5)(p=0.019)。多变量分析证实，额外放疗可逐渐改善 OS，根治性放疗、部分放疗、无按方案放疗的风险比 (HR) 为 1 v 1.8 v 2.4 (p=0.022)。对所有疾病部位进行放疗似乎可以改善转移性儿童的预后可行时应考虑 RMS。如果不可行，仍建议对原发部位和涉及区域淋巴结肿大进行放射治疗。考虑到各组之间的异质性以及本分析中潜在的混杂因素，需要随机临床试验来证实这些发现。版权所有 © 2024。由 Elsevier Inc. 出版。

Radiation oncologists utilize radiation variably for children with metastatic rhabdomyosarcoma (RMS). Data from the XXXX study was retrospectively analyzed to validate the prior observation that the use of radiation is associated with improved outcomes, and guide future recommendations on radiation use in this patient group.The radiation delivered to 216 patients aged 0-21 years with metastatic RMS was retrospectively reviewed and classified as radical (all sites of disease irradiated within the protocol parameters), partial (some sites irradiated within the protocol parameters) and none (no radiation or delivered outside the protocol parameters). Landmark analysis excluded those with an event prior to day 221. Overall survival (OS) and progression free survival (PFS) were modelled using the Kaplan-Meier method to investigate the impact of radiation. The joint effect of treatment and known prognostic factors was examined using the Cox regression model.Overall 56 patients received radical, 104 partial and 56 no radiation per protocol. Due to non-randomised data, the groups were heterogeneous, particularly fewer sites of metatatic disease and less with bone metatases in those receiving radical radiation. 3-year PFS was 62.0% (95%CI 47.9-73.4) v 39.5% (29.8-49.1) v 30.1% (18.7-42.3)(p=0.002) for radical v partial v no radiotherapy respectively; 3-year OS was 70.1 % (55.8-80.6) v 53.1% (42.6-62.5) v 52.3% (38.3-64.5)(p=0.019) respectively. Multivariable analysis confirmed incremental improvement in OS with additional radiation with hazard ratio (HR) 1 v 1.8 v 2.4 (p=0.022) for radical v partial v no per protocol radiation.Radiation to all sites of disease seems to improve outcomes for children with metastatic RMS and should be considered when feasible. If not feasible, radiation is still recommended to the primary site and involved regional lymphadenopathy. Randomized clinical trials are required to confirm these findings, given the heterogeneity between the groups and potential confounding factors in this analysis.Copyright © 2024. Published by Elsevier Inc.