NCCN Releases New Guidelines for Pediatric Rhabdomyosarcoma Care

Comprehensive guidelines aim to optimize treatment and minimize long-term complications for young RMS patients.

Published on Feb. 22, 2026

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The National Comprehensive Cancer Network (NCCN) has published new clinical practice guidelines focused on improving care for children and young adults with rhabdomyosarcoma (RMS), the most common type of soft tissue sarcoma in individuals under 20. The guidelines provide a roadmap for diagnosis, risk stratification, and tailored treatment approaches, balancing effective therapies with minimizing adverse effects.

Why it matters

Rhabdomyosarcoma is a complex disease that can present with varying subtypes driven by different genetic changes, impacting treatment outcomes. These specialized guidelines recognize that childhood cancers differ fundamentally from adult cancers, and convene expert panels to develop recommendations specific to the unique needs of pediatric patients.

The details

The guidelines offer detailed considerations for various tumor locations, risk stratification criteria, and corresponding treatment options. They also emphasize ongoing surveillance and address potential long-term effects of cancer treatment, such as chemotherapy-related vasospastic attacks, radiation-induced secondary cancers, and surgical complications.

  • The new guidelines were published on February 17, 2026.
  • The NCCN guidelines are slated for annual updates to reflect the latest research and clinical insights.

The players

National Comprehensive Cancer Network (NCCN)

A not-for-profit alliance of leading cancer centers dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives.

Stephen Skapek, MD

Chair of the NCCN Guidelines Panel for Pediatric Soft Tissue Sarcoma and chief of the Division of Pediatric Hematology-Oncology at Duke Cancer Institute.

Douglas Hawkins, MD

Vice-chair of the NCCN panel and professor of Hematology-Oncology at Seattle Children's Hospital.

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What they’re saying

“RMS can be divided into specific subtypes that are driven by different genetic changes that can influence outcomes.”

— Stephen Skapek, MD, Chair of the NCCN Guidelines Panel for Pediatric Soft Tissue Sarcoma

“Children are most likely to be diagnosed with RMS at a very young age, toddlers or early elementary school. When treating someone so young, you are not looking to just prolong survival; the goal is a full cure with minimal [adverse] effects and zero recurrence.”

— Douglas Hawkins, MD, Vice-chair of the NCCN panel

What’s next

The NCCN guidelines are slated for annual updates, reflecting the latest research and clinical insights.

The takeaway

These new NCCN guidelines for pediatric rhabdomyosarcoma represent a significant advancement in the standardized and evidence-based care of this complex childhood cancer, aiming to optimize treatment outcomes and minimize long-term complications for young patients.