Casey DL, et al. – Via analyzing a sample of patients with intermediate-risk rhabdomyosarcoma (n=424) treated on Children's Oncology Group (COG) protocol ARST0531, researchers assessed local control. Patients were randomized to receive chemotherapy with either vincristine, dactinomycin, and cyclophosphamide (VAC) or VAC alternating with vincristine and irinotecan. In an effort to improve local control, patients underwent radiation therapy early at week 4 and was concurrent with irinotecan in the experimental arm. Local failure on ARST0531 was compared with local failure on the preceding COG intermediate-risk study, D9803.Overall, local control was inferior on ARST0531 vsD9803, despite interventions designed to improve local control. Although the reason for this is unclear, the investigators suggested that it could be due to the reduced cyclophosphamide dose on ARST0531.