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Intergroup Rhabdomyosarcoma Study I\u2013IV demonstrated that patients with alveolar RMS (ARMS), Group III disease, or clinically involved regional lymph nodes had a worse prognosis. The outcomes and prognostic features of patients with nonorbital, nonparameningeal head and neck (NONPHN) RMS treated in subsequent Children's Oncology Group (COG) trials have not been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Patients enrolled in COG low\u2010risk (D9602 or ARST0331), intermediate\u2010risk (D9803 or ARST0531), and high\u2010risk (D9802, ARST0431, or ARST08P1) trials were included. All patients received chemotherapy. Those with Group I (completely resected) ARMS and those with Group II (microscopic residual) or Group III (macroscopic residual) RMS received 36\u201350.4\u00a0Gy adjuvant radiotherapy (RT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred seventy\u2010two patients with NONPHN RMS were treated across the seven trials. Most patients had cheek primaries (30%), Group II (38%) or Group III (34%) disease, no clinical or radiological evidence of nodal involvement (N<jats:sub>0<\/jats:sub>, 80%), and received RT (70%). The median follow\u2010up was 7.7 years. Five\u2010year event\u2010free survival and overall survival were 70.8% and 83.7%, respectively. The regional failure rate for patients with N<jats:sub>0<\/jats:sub> disease was 2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Outcomes for patients with NONPHN RMS were similar to contemporary studies. Despite lower RT target volumes on the ARST\u2010series versus the D\u2010series protocols, patients with Group III tumors maintained comparable outcomes. Low regional failure rates suggested that sentinel lymph node sampling in patients with N<jats:sub>0<\/jats:sub> disease and elective nodal RT in patients with ARMS and N<jats:sub>0<\/jats:sub> disease are not necessary.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31673","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T04:28:27Z","timestamp":1742444907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nonorbital, Nonparameningeal Head and Neck Rhabdomyosarcoma: A Report From the Children's Oncology Group"],"prefix":"10.1002","volume":"72","author":[{"given":"Jamie M.","family":"Aye","sequence":"first","affiliation":[{"name":"Department of Pediatrics Children's of Alabama University of Alabama at Birmingham  Birmingham USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Biostatistics College of Public Health and Health Professions College of Medicine University of Florida  Gainesville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengya","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics College of Public Health and Health Professions College of Medicine University of Florida  Gainesville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Ladra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences John Hopkins Kimmel Cancer Center at Sibley Memorial Hospital Johns Hopkins School of Medicine  Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-1873","authenticated-orcid":false,"given":"Daniel J.","family":"Indelicato","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida  Jacksonville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Sheyn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Le Bonheur Children's Hospital University of Tennessee Science Center  Knoxville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshni","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center University of Cincinnati College of Medicine  Cincinnati USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Children's Hospital Colorado  Aurora USA"},{"name":"Department of Pathology University of Colorado Anschutz Medical Campus  Aurora USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archana","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Nationwide Children's Hospital  Columbus USA"},{"name":"Department of Pathology The Ohio State University College of Medicine  Columbus USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne M.","family":"Linardic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke University Medical Center Duke University School of Medicine  Durham USA"},{"name":"Department of Pharmacology and Cancer Biology Duke University Medical Center Duke University School of Medicine  Durham USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajkumar","family":"Venkatramani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Texas Children's Hospital Baylor College of Medicine  Houston USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110403"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1987.5.1.46"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.3801"},{"issue":"2","key":"e_1_2_9_5_1","first-page":"62","article-title":"A Case Report of Rhabdomyosarcoma of Cheek","volume":"18","author":"Alli A. 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