Favorable outcomes after whole abdominopelvic radiation therapy for pediatric and young adult sarcoma Journal Article
| Authors: | Casey, D. L.; Wexler, L. H.; LaQuaglia, M. P.; Meyers, P. A.; Wolden, S. L. |
| Article Title: | Favorable outcomes after whole abdominopelvic radiation therapy for pediatric and young adult sarcoma |
| Abstract: | Background: Current Children's Oncology Group (COG) guidelines recommend 24Gy whole abdominopelvic radiation therapy (WAP-RT) for pediatric patients with sarcoma with peritoneal dissemination and/or malignant ascites. However, WAP-RT has never been described for pediatric sarcoma excluding desmoplastic small round-cell tumor (DSRCT). The objective of this study was to evaluate feasibility, outcomes, and toxicity of WAP-RT in children with sarcoma and peritoneal dissemination. Procedure: Detailed records of all 10 pediatric patients with sarcoma (excluding DSRCT) treated with WAP-RT from 2001 to 2013 were reviewed. Results: Median age was 9.9 years (range, 1.7-33.8). Seven patients had rhabdomyosarcoma, 2 embryonal undifferentiated sarcoma of the liver, and 1 Ewing sarcoma. Patients received a median dose of 24Gy with intensity-modulated radiation therapy (IMRT) to the whole abdomen and pelvis. Two patients did not complete treatment, one due to transfusion-resistant pancytopenia and one due to moderate acute gastrointestinal toxicity. At a median follow-up of 4.0 years, both relapse-free survival and overall survival were 100%. Acute hematologic toxicities were common, with 40% of patients developing a grade 4 hematologic toxicity. Most acute gastrointestinal toxicities were grade 1 and managed appropriately with anti-diarrheals and anti-emetics. Late effects varied, and half of patients are without long-term sequelae. Conclusions: All patients remain free of disease, both locally and distantly. Although WAP-RT was associated with acute and late toxicity, treatment was feasible with supportive care. Given the excellent rates of tumor control, we recommend that all providers give WAP-RT with IMRT to patients with pediatric sarcoma and peritoneal dissemination and/or malignant ascites. © 2014 Wiley Periodicals, Inc. |
| Keywords: | sarcoma; radiation oncology; radiation therapy; late effects of cancer treatment |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 61 |
| Issue: | 9 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2014-09-01 |
| Start Page: | 1565 |
| End Page: | 1569 |
| Language: | English |
| DOI: | 10.1002/pbc.25088 |
| PROVIDER: | scopus |
| PUBMED: | 24798662 |
| DOI/URL: | |
| Notes: | Export Date: 1 August 2014 -- CODEN: PBCEA -- Source: Scopus |
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412La Quaglia -
560Wolden -
192Wexler -
311Meyers -
55Casey
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