Local control with 21-Gy radiation therapy for high-risk neuroblastoma Journal Article
| Authors: | Casey, D. L.; Kushner, B. H.; Cheung, N. K. V.; Modak, S.; LaQuaglia, M. P.; Wolden, S. L. |
| Article Title: | Local control with 21-Gy radiation therapy for high-risk neuroblastoma |
| Abstract: | Purpose To evaluate local control after 21-Gy radiation therapy (RT) to the primary site in patients with high-risk neuroblastoma. Methods and Materials After receiving dose-intensive chemotherapy and gross total resection (GTR), 246 patients (aged 1.2-17.9 years, median 4.0 years) with high-risk neuroblastoma underwent RT to the primary site at Memorial Sloan Kettering from 2000 to 2014. Radiation therapy consisted of 21 Gy in twice-daily fractions of 1.5 Gy each. Local failure (LF) was correlated with biologic prognostic factors and clinical findings at the time of diagnosis and start of RT. Results Median follow-up of surviving patients was 6.4 years. Cumulative incidence of LF was 7.1% at 2 years after RT and 9.8% at 5 years after RT. The isolated LF rate was 3.0%. Eighty-six percent of all local failures were within the RT field. Local control was worse in patients who required more than 1 surgical resection to achieve GTR (22.4% vs 8.3%, P=.01). There was also a trend toward inferior local control with MYCN-amplified tumors or serum lactate dehydrogenase ≥1500 U/L (P=.09 and P=.06, respectively). Conclusion After intensive chemotherapy and maximal surgical debulking, hyperfractionated RT with 21 Gy in high-risk neuroblastoma results in excellent local control. Given the young patient age, concern for late effects, and local control >90%, dose reduction may be appropriate for patients without MYCN amplification who achieve GTR. © 2016 Elsevier Inc. |
| Keywords: | chemotherapy; radiotherapy; diagnosis; prognostic factors; surgery; lactate dehydrogenase; surgical resection; patient treatment; cumulative incidence; high-risk neuroblastoma; dose reduction; twice-daily fractions; methods and materials |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 96 |
| Issue: | 2 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2016-10-01 |
| Start Page: | 393 |
| End Page: | 400 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2016.05.020 |
| PROVIDER: | scopus |
| PUBMED: | 27473818 |
| PMCID: | PMC5476959 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 December 2016 -- Source: Scopus |
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