Aggressive treatment is not warranted in patients with pediatric rhabdomyosarcoma (RMS), a malignant soft tissue tumor in the muscle tissue of children, according to a multi-site analysis of CT scans published in the Journal of Clinical Oncology.

In the Netherlands, about 20 children per year are diagnosed with RMS. In these patients, small spots are normally detected in the CT scans of the lungs. Until now, however, it was unknown if patients with these small spots had the same prognosis as those without.

The researchers examined CT scans of 316 patients (67 with indeterminate pulmonary nodules, 249 with no pulmonary nodules) with RMS. Patients were chosen from pediatric oncology centers in the U.K., France, Italy and the Netherlands who received a diagnosis between September 2005 and December 2013.

Overall, the prospects of the children with small spots proved to be just as good as those in children without abnormal findings on their CT scans. Specifically, after a median follow-up of 75 months, the five-year event-free survival and overall survival ratees were 77 percent and 82 percent, respectively, for those with indeterminate nodules. For those without nodules at diagnosis, event-free and overall survival were 73 percent and 81 percent, respectively.

"This is good news," said study leader, Hans Merks, MD, PhD, of the Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, who led the study, in a news release. "It means that these children do not need to be treated with extra strong medicines that are potentially harmful to the heart; they also do not need to be treated for longer or need radiation on their lungs, as is the case when children have larger lung metastases."