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Table 5. Radiation Therapy (RT) Dose According to Rhabdomyosarcoma Group, Histology, and Site of Disease (Children's Oncology Group [COG])

Group Treatment 
Group I
EmbryonalNo RT.
Alveolar36 Gy to involved (prechemotherapy) site. The use of RT is under investigation.
Group II
N0 (microscopic residual disease after surgery)36 Gy to involved (prechemotherapy) site.
N1 (resected regional lymph node involvement)41.4 Gy to involved (prechemotherapy) site and nodes.
Group III
Orbital and nonorbital tumors50.4 Gy with volume reduction after 36 Gy if excellent response to chemotherapy and noninvasive pushing tumors; no volume reduction for invasive tumors.
Group IV
As for other groups and including all metastatic sites, if safe and possible. Exception: lung (pulmonary metastases) treated with 15 Gy if aged 6 years or older, 12 Gy if younger than 6 years.