Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma Journal Article

  


Authors: Rich, B. S.; McEvoy, M. P.; LaQuaglia, M. P.; Wolden, S. L.
Article Title: Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma
Abstract: Background/Purpose: Patients with locally recurrent or persistent high-risk neuroblastoma are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. Methods: We retrospectively reviewed 44 consecutive patients who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent tumor. Specifically, we evaluated local recurrence rates, complications, and overall survival. Results: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each patient received prior chemotherapy and surgery, while 94.5% had previous external beam radiation therapy. MYCN was amplified in 34% of patients. There were no operative or postoperative deaths, and 18 patients (40.9%) had postoperative complications. There was a 50.4% probability of local control. MYCN amplification did not affect local control (local recurrence rate of 53.9% vs 52.4%, P = .89). Median overall survival was 18.7 months (95% confidence interval, 11.7-25.6 months). Mean survival for MYCN-amplified patients was 13.0 vs 39.2 months for those without MYCN amplification (P = .035). Conclusions: Intraoperative radiation therapy after re-resection of locally recurrent/persistent neuroblastoma results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population. © 2011 Elsevier Inc. All rights reserved.
Keywords: adolescent; adult; cancer chemotherapy; cancer survival; child; clinical article; preschool child; school child; cancer surgery; cancer recurrence; cancer risk; follow up; gene amplification; morbidity; cancer mortality; postoperative complication; oncogene; infant; neuroblastoma; reoperation; external beam radiotherapy; high risk population; cancer control; intraoperative radiotherapy; recurrent; iort; persistent; mycn oncogene
Journal Title: Journal of Pediatric Surgery
Volume: 46
Issue: 1
ISSN: 0022-3468
Publisher: W.B. Saunders Co-Elsevier Inc.  
Date Published: 2011-01-01
Start Page: 97
End Page: 102
Language: English
DOI: 10.1016/j.jpedsurg.2010.09.068
PROVIDER: scopus
PUBMED: 21238648
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-78751531104&partnerID=40&md5=6834fa7e26b34d6001ca4f487b65b54d
Notes: --- - "Export Date: 4 March 2011" - "CODEN: JPDSA" - "Source: Scopus"
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MSK Authors
  1. Michael P La Quaglia
    411 La Quaglia
  2. Suzanne L Wolden
    560 Wolden
  3. Maureen Patricia Mcevoy
    10 Mcevoy
  4. Barrie S Rich
    14 Rich
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