Rhabdomyosarcoma is mainly surgical resection, which includes all muscles where the tumor is located. For embryonal rhabdomyosarcoma, besides resection, chemotherapy and radiotherapy should be combined to relieve symptoms. Polymorphic rhabdomyosarcoma is ineffective in chemotherapy and radiotherapy.
Tumor biopsy showed that complete surgical resection of rhabdomyosarcoma was effective. Only 10% of patients with rhabdomyosarcoma can be completely removed. Even in patients with complete resection, because rhabdomyosarcoma is easy to metastasize, chemotherapy and radiotherapy are necessary.
During the operation, lymph nodes in the tumor area should be biopsied. Complete surgical resection of rhabdomyosarcoma of the head and neck requires consultation from otolaryngologists, plastic surgeons, maxillofacial surgeons and neurosurgeons. If complete excision affects facial appearance and function, the operation will be delayed until the end of chemotherapy and radiotherapy. Whether to perform a second facial surgery depends on the surgical site and the effect of radiotherapy and chemotherapy.
The basic requirement of rhabdomyosarcoma surgical resection is biopsy. The form of biopsy is based on medical imaging results, tumor location and size, patient's age and health status, and doctor's experience. The purpose of radical resection of tumor during operation is to avoid secondary operation.
2. Chemotherapy
When rhabdomyosarcoma cannot be completely removed, all patients must receive chemotherapy. Chemotherapy can completely eliminate residual tumors. Even if the tumor seems to have been completely removed, chemotherapy is still necessary.
There are many cytotoxic chemotherapy drugs, most of which are intravenous injection. The main drugs used for complete excision of embryonic rhabdomyosarcoma are vincristine and gengmycin, and cyclophosphamide is also commonly used for class II and III tumors.
Ifosfamide can kill rhabdomyosarcoma cells, which is expected to improve the survival rate of patients with grade ⅳ. Chemotherapy drugs can also kill some normal cells and produce side effects. Side effects include alopecia, nausea, vomiting, loss of appetite, fatigue, anemia and susceptibility to infection. After drug withdrawal, most of the side effects will disappear, and some drugs will permanently damage the cells in the ovary and testis, leading to fertility difficulties or even infertility. The damage of cyclophosphamide or ifosfamide to kidney and bladder is also permanent.
3. Radiotherapy
For rhabdomyosarcoma, radiotherapy is a very effective method and can be used as an auxiliary treatment for surgical treatment. The radiation dose should be selected according to the age and location, and the irradiation field should include the tumor bed and the surrounding normal tissues of 2 ~ 5 cm, and the effective radiation dose should not be less than 40Gy.
4. Magnetic induction therapy
The principle of magnetic induction therapy is that ferromagnetic materials generate heat under alternating magnetic field to raise the temperature of tumor tissue to an effective temperature, thus achieving the therapeutic purpose. Magnetic induction therapy has the characteristics of targeting, conformity, self-control temperature, internal heat, repeatability and large temperature difference between normal tissue and tumor. It is expected to overcome the shortcomings of previous local hyperthermia methods for tumors and become a new effective means to treat tumors.