Vincristine, Dactinomycin, and Cyclophosphamide With or Without Radiation Therapy in Treating Patients With Embryonal Rhabdomyosarcoma

DISEASE CHARACTERISTICS:

• Diagnosis of embryonal rhabdomyosarcoma

  • Primary operation for pathological diagnosis within the past 42 days

  • The following variants are eligible:

    • Botryoid
    • Spindle cell
    • Anaplastic

• Meets 1 of the following stage criteria:

  • Stage I, clinical group I or II (N0), defined by all of the following criteria:

    • Favorable site, including orbit, head, and neck (excluding parameningeal sites), genitourinary region (excluding bladder/prostate sites), or biliary tract
    • Tumor any size
    • Completely resected disease OR microscopic residual disease
    • Lymph nodes clinically negative

  • Stage I, clinical group III (N0), defined by all of the following criteria:

    • Favorable site
    • Tumor any size
    • Gross residual disease allowed (orbit only)
    • Lymph nodes clinically negative

  • Stage II, clinical group I (N0, Nx), defined by all of the following criteria:

    • Unfavorable site (any sites not listed as favorable sites)
    • Tumor ≤ 5 cm in diameter
    • Completely resected disease
    • Lymph nodes clinically negative OR lymph node involvement unknown

PATIENT CHARACTERISTICS:

Performance status

• 0-3

Life expectancy

• Not specified

Hematopoietic

• WBC ≥ 2,000/mm\^3
• Platelet count ≥ 100,000/mm\^3
• Hemoglobin ≥ 7.5 g/dL

Hepatic

• SGOT and SGPT ≤ 2.5 times upper limit of normal (ULN)
• Bilirubin ≤ 2.5 times ULN
• Bile acid ≤ 2.5 times ULN

Renal

• Creatinine based on age as follows:

  • \< 0.8 mg/dL (for patients \< 5 years of age)
  • \< 1.2 mg/dL (for patients 5-9 years of age)
  • \< 1.5 mg/dL (for patients ≥ 10 years of age)

Cardiovascular

• No severe heart disease

Other

• Not pregnant or nursing
• Must have acceptable organ function for age
• No uncontrolled infection
• No other active malignancy
• No other treated malignancy within the past 5 years
• No hypersensitivity to study drugs
• No Charcot-Marie-Tooth disease
• No chickenpox

PRIOR CONCURRENT THERAPY:

Chemotherapy

• No prior anticancer chemotherapy

Endocrine therapy

• Prior anticancer steroids allowed

Radiotherapy

• No prior radiotherapy

Other

• No concurrent pentostatin