Objective  To analyze the clinical significance and value of three-dimensional radiotherapy in comprehensive treatment of initial or recurring pediatric head-and-neck rhabdomyosarcoma.

  Methods  Retrospective analysis of 24 patients diagnosed with head-and-neck rhabdomyosarcoma between January 2002 and January 2009 was conducted. Twenty two of these patients (12 males and 10 females) received three-dimensional radiotherapy, intensity-modulated radiotherapy, and cyberknife radiotherapy as part of a multimodal therapy. The median prescribed dose was 50.4 Gy (28 Gy to 60 Gy). The median duration of follow-up for surviving patients was 42 months.

  Results  The postoperative clinical grouping of these 22 patients is 1 patient in Group I, 6 in Group II, 14 in Group III, and 1 in Group IV. Median age at the time of radiation therapy was 6.5 years old. All patients were treated with multipie-agent chemotherapy and external beam radiotherapy. The 2-year overall survival and local control rates were 68.18% (15/22) and 77.27% (17/22). The 2-year overall survival and local control rates of recurrence or metastasis in patients were 55.56% (5/9) and 66.67% (6/9), respectively. Six patients died from distant metastases. Most of the patients only suffered from local edema mucosa ulcer. No late toxicities were observed and no secondary malignancies occurred as of the writing of this paper.

  Conclusion  Three-dimensional conformal radiotherapy can lead to better outcome compared with common radiotherapy technique in children with head-and-neck RMS. Moreover, high local control rates and a low incidence of treatment-related side effects can be achieved.