{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:55:54Z","timestamp":1785862554781,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung metastases in patients with metastatic rhabdomyosarcoma (RMS) have not been treated uniformly across Europe. This provides comparison of the impact of whole lung irradiation (WLI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Lung\u2010metastatic patients included in the Cooperative Weichteilsarkom Studiengruppe\u2010IV 2002, European Pediatric Soft Tissue Sarcoma Study Group MTS 2008 or the Soft Tissue Sarcoma Registry received four\u2010 or six\u2010drug chemotherapy, surgery, and\/or irradiation (radiotherapy) of the primary tumor. Treatment of lung lesions consisted of metastasectomy, WLI, or no local treatment according to protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 238 patients with lung\u2010metastatic RMS were included. Half of these patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0119\/238) had lung metastases only (median age, 6.6 years), mainly classified as embryonal RMS (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a093\/119, 78%). Lung\u2010only patients underwent metastasectomy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a017) and\/or WLI (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a031) or no local treatment of lung metastases (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a071). Early complete response of lung metastases was associated with favorable 3\u2010year overall survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.009). A trend toward improved event\u2010free survival after WLI could be identified in patients \u226510 years old (hazard ratio [HR], 2.7; 95% CI, 0.8\u20139.6), but not in patients under 10 years old (HR, 0.86; 95% CI, 0.44\u20131.66). Lung\u2013relapse\u2010free survival (lung\u2010RFS) was not influenced by WLI or metastasectomy in the univariable and multivariable analyses. When analyzing all lung\u2010metastatic patients (including those with metastases in other sites,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0238), WLI in patients older than 10 years was a significant prognostic factor (HR, 2.2; 95% CI, 1.0\u20134.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The analysis failed to show a significant benefit of WLI in patients with lung\u2010metastatic RMS, apart from the subgroup of patients older than 10 years. Lung\u2010RFS was not influenced by WLI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70530","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:26:37Z","timestamp":1784834797000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of whole lung irradiation in lung metastatic rhabdomyosarcoma: A pooled analysis of two European trials and one European registry"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3472-9679","authenticated-orcid":false,"given":"Amadeus T.","family":"Heinz","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u2019s Hospital Tuebingen  Tuebingen Germany"},{"name":"Stuttgart Cancer Center, Zentrum f\u00fcr Kinder\u2010, Jugend\u2010 und Frauenmedizin (Olgahospital) P\u00e4diatrie 5 (P\u00e4diatrische Onkologie, H\u00e4matologie, Immunologie) Klinikum der Landeshauptstadt Stuttgart  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Heesen","sequence":"additional","affiliation":[{"name":"University Hospital USZ University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes H. M.","family":"Merks","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Division of Imaging and Oncology University Medical Center Utrecht University of Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-5207","authenticated-orcid":false,"given":"V\u00e9ronique","family":"Minard\u2010Colin","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Oncology Gustave Roussy Universit\u00e9 Paris\u2010Saclay  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u2019s Hospital Tuebingen  Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison L.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Bristol Haematology and Oncology Centre University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1195-7150","authenticated-orcid":false,"given":"Semi","family":"Harrabi","sequence":"additional","affiliation":[{"name":"Department of Radiooncology and Radiotherapy Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Mandeville","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Royal Marsden NHS Foundation Trust Institute of Cancer Research  Sutton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reineke A.","family":"Schoot","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology University Children\u2019s Hospital  Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Guillen","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department Hospital Universitari Vall d'Hebron Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-7569","authenticated-orcid":false,"given":"Ewa","family":"Koscielniak","sequence":"additional","affiliation":[{"name":"Medical Faculty University Tuebingen  Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3479-7997","authenticated-orcid":false,"given":"Julia 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