Journal of Orthopedic Oncology
Open Access

Rhabdomyosarcoma; Multidisciplinary care; Soft tissue sarcoma; Pediatric oncology; Chemotherapy; Radiation therapy

Introduction

Rhabdomyosarcoma (RMS) is a rare and highly malignant soft tissue tumor that arises from the skeletal muscle precursor cells. It predominantly affects children and adolescents, though it can also be diagnosed in adults. RMS accounts for approximately 3% of all pediatric cancers and is the most common soft tissue sarcoma in children [1]. The tumor can develop in any part of the body, with common sites including the head and neck, genitourinary tract, and extremities. The clinical presentation of RMS varies depending on the tumor's location, size, and the age of the patient, with symptoms ranging from palpable masses to organ dysfunction [2]. Despite advances in chemotherapy, radiation, and surgical techniques, the prognosis for RMS patients can be quite variable, particularly for those with high-risk or metastatic disease at diagnosis. Factors such as histological subtype, tumor size, location, and response to initial therapy play significant roles in determining treatment strategies and overall outcomes. Multidisciplinary care has become a cornerstone of effective management for RMS, as it allows for a comprehensive and coordinated approach to treatment [3]. This approach involves a team of specialists from various fields oncology, surgery, radiology, pathology, and supportive care working together to ensure that each aspect of the patient's care is addressed. This paper explores the critical role of multidisciplinary care in the treatment of rhabdomyosarcoma, highlighting how the collaboration of healthcare professionals improves treatment efficacy, reduces complications, and ultimately enhances the quality of life for patients. Emphasis will be placed on the integration of surgical, chemotherapeutic, and radiation therapies, as well as the importance of personalized and patient-centered care in optimizing outcomes for individuals diagnosed with RMS [4].

Discussion

Rhabdomyosarcoma (RMS) is a challenging malignancy due to its heterogeneous nature, diverse presentation, and propensity for metastasis. The complexity of treating RMS necessitates a multidisciplinary approach, where expertise from various medical specialties is integrated to provide the best possible care. The role of multidisciplinary care in the management of RMS is paramount, as it ensures that treatment plans are comprehensive, personalized, and tailored to the individual patient’s needs. Surgical resection remains a cornerstone of RMS treatment, particularly for localized tumors. The goal of surgery is to achieve complete excision with clear margins, thereby minimizing the risk of recurrence. However, achieving complete resection is often difficult due to the tumor's infiltrative nature and proximity to vital structures, especially in head and neck or pelvic RMS cases. In these situations, a multidisciplinary team, including oncologic surgeons, radiologists, and pathologists, must work closely to plan the optimal surgical approach and ensure the feasibility of resection without compromising critical function or cosmetic appearance. Furthermore, intraoperative assistance from reconstructive surgeons may be necessary to maintain the function of affected organs or tissues [5].

Chemotherapy plays a critical role in the management of RMS, particularly in high-risk patients or those with metastatic disease. Multi-agent chemotherapy regimens, such as vincristine, actinomycin D, and cyclophosphamide (VAC), have shown significant effectiveness in shrinking tumors and controlling micrometastatic disease. Radiation therapy is often employed as an adjunct to surgery or chemotherapy, particularly in cases where complete surgical resection is not possible or in high-risk tumors. Radiotherapy targets residual tumor cells, reducing the risk of local recurrence and controlling disease progression [6]. Multidisciplinary input from medical oncologists, radiation oncologists, and surgeons ensures that chemotherapy and radiation are delivered optimally based on tumor location, size, and response to treatment. In recent years, the emergence of molecular diagnostics and genomic profiling has enabled more personalized treatment strategies for RMS. Identifying specific genetic mutations, chromosomal abnormalities, and molecular markers associated with RMS subtypes allows for targeted therapies that can improve the effectiveness of treatment while minimizing adverse effects [7]. The role of precision medicine, including the use of targeted agents such as tyrosine kinase inhibitors or immunotherapy, is an area of active research in RMS. In these cases, the collaboration of geneticists, oncologists, and molecular biologists is essential for identifying the most appropriate therapies for each patient. In cases of advanced or metastatic RMS, the focus of care often shifts towards symptom management and improving the patient’s quality of life. Palliative care is a crucial component of multidisciplinary care, especially for patients with poor prognoses. Pain management, psychosocial support, and the integration of emotional care are important to address the psychological burden of a cancer diagnosis. The inclusion of palliative care specialists, counselors, and social workers ensures that patients and their families are supported throughout the treatment journey, addressing not only physical but also emotional, social, and spiritual needs [8]. The complexity of RMS demands coordination between various specialists to provide optimal care. Oncologists, surgeons, radiation therapists, pathologists, and palliative care teams must collaborate from diagnosis through treatment and follow-up. Regular case discussions, tumor board meetings, and personalized treatment plans help ensure that all aspects of care are addressed and that treatment is adapted to the evolving needs of the patient. This teamwork ensures that patients receive comprehensive care that improves both survival outcomes and quality of life.

Despite the successes of multidisciplinary care, challenges remain in treating RMS, particularly for patients with recurrent or metastatic disease [9]. Current research is focused on exploring new chemotherapy regimens, novel molecular targets, and immunotherapies to improve outcomes for high-risk patients. Additionally, further investigation into the genetic underpinnings of RMS may lead to the development of more effective, personalized therapies. The future of RMS treatment will likely involve an increasing reliance on precision medicine, as well as novel combination therapies that target both the tumor and its microenvironment. In conclusion, the multidisciplinary approach to treating rhabdomyosarcoma is essential for achieving optimal patient outcomes. By integrating expertise from various medical specialties, healthcare teams can ensure that treatment is comprehensive, individualized, and holistic. While challenges remain in the treatment of RMS, ongoing research and collaboration across disciplines continue to enhance the effectiveness of therapies and improve the quality of care for patients diagnosed with this aggressive cancer [10].

Conclusion

Rhabdomyosarcoma (RMS) remains a complex and challenging malignancy that requires a comprehensive, multidisciplinary approach to ensure the best possible outcomes for patients. The integration of surgical, chemotherapy, radiation therapy, and supportive care is critical for effectively managing RMS, particularly in cases with high risk, recurrence, or metastasis. The involvement of various specialists—oncologists, surgeons, radiologists, pathologists, and palliative care teams ensures that treatment is well-coordinated, personalized, and responsive to the individual needs of each patient. Advancements in molecular diagnostics and precision medicine offer promising avenues for developing more targeted therapies, potentially improving treatment efficacy while reducing side effects. However, despite these advances, challenges remain, particularly in the management of recurrent or metastatic RMS. Future research and the continued collaboration of interdisciplinary teams are essential to further refine treatment strategies, optimize patient outcomes, and enhance the quality of life for those affected by RMS. In conclusion, the success of RMS treatment is highly dependent on the collaborative efforts of a dedicated multidisciplinary team, focused on both oncological control and patient-centered care. By continuing to push the boundaries of research and treatment options, we can improve survival rates, reduce complications, and provide holistic care to patients diagnosed with this aggressive tumor.

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