Intraoperative high-dose-rate brachytherapy for pediatric solid tumors: A 10-year experience Journal Article
| Authors: | Goodman, K. A.; Wolden, S. L.; LaQuaglia, M. P.; Alektiar, K.; D'souza, D.; Zelefsky, M. J. |
| Article Title: | Intraoperative high-dose-rate brachytherapy for pediatric solid tumors: A 10-year experience |
| Abstract: | Purpose: To evaluate the efficacy and toxicity of intraoperative high-dose-rate brachytherapy (IOHDR) in the management of pediatric solid tumors. Methods and Materials: The records of 66 pediatric patients who underwent IOHDR for a solid tumor from February 1993 through December 2002 were retrospectively reviewed. The median age was 7 years (range 9 months to 24 years). Thirty-five patients (53%) were treated for recurrent disease and 24 (36%) had documented metastatic disease. Twenty-nine patients (44%) received both EBRT and IOHDR. The IOHDR dose was prescribed to a depth of 0.5cm from the surface of a multichannel tissue-equivalent applicator. The median prescription dose was 12 Gy (range, 4-15 Gy). Results: After a median follow-up of 12 months, the 2-year actuarial rates of local control and overall survival were 56% and 54%, respectively, with a median survival of 29 months. Post-operative EBRT significantly improved (p = 0.002) 2-year local control (83% v. 29%). Perioperative complications occurred in 8 of 66 patients while late complications occurred in only 3. The actuarial 2-year late complication rate was 12%. Late events that occurred in or near the IOHDR treatment site included small bowel obstruction, broncho-esophageal fistula, and bone growth retardation. Conclusions: IOHDR is emerging as an integral part of multimodality therapy for pediatric solid tumors as an adjunct to EBRT for local control. IOHDR alone may not be appropriate in the majority of patients. Subacute toxicities occurred rarely and may be related to the combination of extensive surgery, EBRT, and multi-agent chemotherapy in this population. © 2003 American Brachytherapy Society. All rights reserved. |
| Keywords: | adolescent; adult; cancer chemotherapy; cancer survival; child; treatment outcome; child, preschool; cancer surgery; retrospective studies; major clinical study; cancer recurrence; multimodality cancer therapy; solid tumor; radiation dose; combined modality therapy; follow up; neoplasms; metastasis; radiotherapy dosage; morbidity; childhood cancer; time factors; sarcoma; postoperative complication; antiinfective agent; infant; intraoperative period; brachytherapy; radiation therapy; cancer control; pediatric tumors; growth retardation; small intestine obstruction; bone growth; esophagobronchial fistula; humans; human; male; female; priority journal; article; intraoperative high-dose-rate brachytherapy |
| Journal Title: | Brachytherapy |
| Volume: | 2 |
| Issue: | 3 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2003-01-01 |
| Start Page: | 139 |
| End Page: | 146 |
| Language: | English |
| DOI: | 10.1016/s1538-4721(03)00135-1 |
| PUBMED: | 15062136 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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