To improve the treatment of children with cancer of several specific types including: Rhabdomyosarcoma; other soft tissue sarcomas; various rare tumors; and intracranial germinoma. Specific aims are 1) To study how to most effectively utilize radiation therapy in the management of pediatric tumors with regard to the specific issues of indications, timing, sequence, treatment volume, and dose intensity; and 2) To assess the late effects of cranial radiotherapy in brain tumor patients and facial radiotherapy in patients with head and neck rhabdomyosarcoma.
Overall Research Summary and Significance
Dr. Wharam’s cooperative group research is done under the auspices of the Children’s Oncology Group. He is one of two senior radiation oncologist members of the Intergroup Rhabdomyosarcoma Study which has recently taken on the responsibility for other soft tissue sarcomas and is now referred to as the Soft Tissue Sarcoma Committee of COG. He is the only radiation oncologist assigned to the Rare Tumor Committee. He is senior advisor to the Radiation Oncology Principal Investigator for the development of the forthcoming phase III trial for children with intracranial germinoma. Current clinical research projects related to these studies include the investigation of local failure risk for patients on Intergroup Rhabdomyosarcoma Study III; a review of all four IRS studies for patients with orbital rhabdomyosaracoma; a study of patients who did not receive required radiotherapy in IRS III and IRS IV; a review of the Hopkins’ experience in patients with intracranial germinoma; and a review of radiotherapy in pediatric patients with low grade glioma. A grant to support the study of magnetic resonance spectroscopy in survivors of childhood brain tumors has been submitted and returned for revision.
The fourth Intergroup Rhabdomyosarcoma Study tested the hypothesis that hyperfractionated radiotherapy would reduce the risk of local failure in certain patient subsets and would also reduce late effects. Dr. Wharam wrote the local control guidelines for the 5th Intergroup Rhabdomyosarcoma Study which for the first time requires a disciplined approach to second-look surgery with response-based radiation dose assignment. This approach will facilitate safe reduction of radiotherapy dose for many children with unresectable rhabdomyosarcoma. These studies and various others support the goal of improved treatment for pediatric oncology patients.
Weiner MA, Leventhal B, Brecher ML, Marcus RB, Cantor A, Gieser PW, Ternbert JL, Behm FG, Wharam MD, Chauvenet AR. Randomized Study of Intensive MOPP-ABVD with or Without Low-dose Total Nodal Radiation Theapy in the Treatment of Stages IIB, IIIA2, IIIB, and IV Hodgkin’s Disease in Pediatric Patients: A Pediatric Oncology Study Group. Clin Oncol 15(8): 2769-2779, 1997.
Wharam MD, Hanfelt JJ, Tefft MC, Johnston J, Ensign LG, Breneman J, Donaldson SS, Fryer C, Gehan EA, Raney RB, Maurer HM. Radiation Therapy for Rhabdomyosarcoma: Local Failure Risk for Clincial Group III Patients on Intergroup Rhabdomyosarcoma Study II. Int J Rad Oncol, Biol, Phys 38(4): 797-804, 1997.
Donaldson SS, Asmar L, Breneman J, Fryer C, Glicksman AS, Laurie F, Wharam D, Gehan EA. Hyperfractionated Radiation in Children with Rhabdomyosarcoma--Results of an Intergroup Rhabdomyosarcoma Pilot Study. Int J Rad Oncol, Biol, Phys 73: 903-911, 1995.
Wharam MD, Beltangady MS, Heyn RM, Lawrence W, Raney RB, Ruymann FB, Soule EH, Tefft M, Maurer HM. Pediatric Orofacial and Laryngopharyngeal Rhabdoymosarcoma: an Intergroup Rhabdomyosarcoma Study Report. Arch Otolaryngol0 Head Neck Surgery 113: 1225-1227, 1987.
Wharam M, Beltangady M, Hays D, Heyn R, Ragab A, Soule E, Tefft M, Maurer H. Localized Orbital Rhabdomyosarcoma. An Interim Report of the Intergroup Rhabdomyosarcoma Study Committee. Ophthal 94: 251-254, 1987.
N.B.: Dr. Moody DeWitt Wharam, M.D. is a great-grandson of James Oldham Wharam. His father, DeWitt Moody Wharam, began the search for our English ancestors.
This site was last updated 08/17/05