Table 1.

COG and EpSSG Treatment Assignment Algorithm

	Number of Patients
COG ARST0332	29
No Adjuvant Therapy	17
IRS group I, any size, POG grade 2	13
IRS group I, ≤5 cm, POG grade 3	4
Adjuvant Radiotherapy	1
IRS group II, ≤5 cm, POG grade 3 (55.8 Gy)	1
Adjuvant Chemotherapy + Radiotherapy	5
IRS group I/II, >5 cm (55.8 Gy)	1
IRS group I/II, ≤5 cm, nodal metastases (55.8 Gy)*	1
IRS group IV, primary tumor grossly resected (55.8 Gy)*	3
Neoadjuvant Chemotherapy + Radiotherapy, Delayed Resection	6
IRS group III, any size (45 Gy plus boost based on surgical margin)†	4
IRS group IV, primary tumor unresected (45 Gy plus boost based on surgical margins)†*	2
EpSSG NRSTS2005	34
No Adjuvant Therapy	13
IRS group I, ≤5 cm, any FNCLCC grade	13
Adjuvant Radiotherapy	3
IRS group I, >5 cm, FNCLCC grade 2 (50.4 Gy)	1
IRS group II, any size, FNCLCC grade 2 (54 Gy)	1
IRS group II, ≤5 cm, FNCLCC grade 3 (54 Gy)	1
Adjuvant Chemotherapy + Radiotherapy	2
IRS group I, >5 cm, FNCLCC grade 3 (50.4 Gy)	1
IRS group II, >5 cm, FNCLCC grade 3 (54 Gy)	1
Neoadjuvant Chemotherapy, Delayed Resection + Pre- or Postoperative Radiotherapy	16
IRS group III (50.4–59.4 Gy depending on resection timing and surgical margins)‡	12
IRS group IV (50.4–59.4 Gy depending on resection timing and surgical margins)‡**	4

FNCLCC: Fédération Nationale des Centres de Luttle Contre Le Cancer; Gy: Gray; IRS: Intergroup Rhabdomyosarcoma Study; POG: Pediatric Oncology Group

^†Primary tumor total dose 45 Gy following R0 resection, 55.8 Gy following R1 resection, 64.8 Gy for gross tumor

^*Resectable nodal and distant metastases excised at delayed surgery or at end of therapy; unresectable metastases received 50 Gy RT when feasible.

^‡50.4 Gy pre-operatively, 50.4 Gy postoperatively following R0 resection, 54 Gy postoperatively following R1 resection, 59.4 Gy for gross tumor

^**Treatment of metastases per investigator choice