Radiation Therapy Dose Escalation Failed to Improve Local Control for Intermediate-Risk Rhabdomyosarcoma on ARST1431: A Report From the Children’s Oncology Group

Jackson CB, Xue W, Gupta AA, Qumseya A, Dasgupta R, Hill-Kayser CE, Spalding AC, Rodeberg DA, Harrison DJ, Venkatramani R, Wolden SL. Radiation Therapy Dose Escalation Failed to Improve Local Control for Intermediate-Risk Rhabdomyosarcoma on ARST1431: A Report From the Children’s Oncology Group. Int J Radiat Oncol Biol Phys. 2025 Sep 1;123(1):54-62. doi: 10.1016/j.ijrobp.2025.03.038. Epub 2025 Apr 2. PMID: 40185209; PMCID: PMC12353335.

To evaluate local failure (LF) rates for patients with intermediate-risk rhabdomyosarcoma (IR-RMS) treated on the Children’s Oncology Group (COG) ARST1431 clinical trial, the first and largest international, phase 3 randomized study to use FOXO1 fusion status for risk stratification. To improve local control, radiation therapy (RT) dose was increased to 59.4 Gy for patients with tumors >5cm and residual gross disease at the time of RT.