This is a retrospective multi-centre analysis performed in France, analyzing the efficacy of various second line regimens in children with relapsed locoregional RMS. 49 children were included who were treated between 1995 and 2013. At relapse, the chemotherapy regimen was at the physician’s discretion. Overall response rate to second line chemo was 39.1%, 5 year OS was 49%. Response rates to various regimens are as follows: CEV/IVE: 11/15 patients: 73.3%, VI[T]: given to 7 patients: 42.9%, IVA/VAC: 0%. Receipt of doxorubicin upfront is associated with poorer outcomes at relapse. Local control was the most important factor in survival.
* It is important to note that salvage rates in Europe may appear higher than in North America because radiotherapy is sometimes used as salvage treatment rather than upfront. Alternatives like oral etoposide can also be used, and in practice sometimes patients receive maintenance chemotherapy with cyclophosphamide/vinorelbine after initial therapy. There is still no standard and local control remains vital.