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Title: Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration

Abstract

Purpose: In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae. Materials and Methods: Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: As of June 2013, 1500 children have been recruited into the RiSK database and 485 into the RADTOX registry leading to an analysis population of 1359 patients (age range 0-18). A total of 18.9% (n=257) of all investigated patients developed high-grade acute toxicity (grades 3/4). High-grade toxicity of the bone marrow was documented for 63.8% (n=201) of those patients, oral mucositis for 7.6% (n=24), and dermatitis for 7.6% (n=24). Patients with high-grade acute toxicity received concomitant chemotherapy more frequently (56%) than patients with no or lower acute toxicity (31.5%). In multivariate analyses, concomitant chemotherapy, diagnosis of Ewing sarcoma, and total radiationmore » dose showed a statistically noticeable effect (P≤.05) on acute toxicity, whereas age, concomitant chemotherapy, Hodgkin lymphoma, Ewing sarcoma, total radiation dose, and acute toxicity influenced the time until maximal late toxicity. Conclusions: Generally, high-grade acute toxicity after irradiation in children and adolescence occurs in a moderate proportion of patients (18.9%). As anticipated, the probability of acute toxicity appeared to depend on the prescribed dose as well as concomitant chemotherapy. The occurrence of chronic toxicity correlates with the prior acute toxicity grade. Age seems to influence the time until maximal late toxicity but not the development of acute toxicity.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [1];  [8];  [1];  [9];  [1]
  1. Department of Radiation Oncology, University Hospital of Muenster, Muenster (Germany)
  2. Institute of Biostatistics and Clinical Research, University of Muenster, Muenster (Germany)
  3. Department of Oncology, University Hospital, Uppsala (Sweden)
  4. Department of Radiation Physics, Skåne University Hospital, Lund (Sweden)
  5. Department of Radiation Oncology, University Hospital of Duesseldorf, Duesseldorf (Germany)
  6. Department of Radiation Oncology, University Hospital of Leipzig, Leipzig (Germany)
  7. Department of Radiation Oncology, University of Regensburg, Regensburg (Germany)
  8. Department of Radiation Oncology, Medical School Hannover, Hannover (Germany)
  9. Department of Radiation Sciences, Umeå University, Umeå (Sweden)
Publication Date:
OSTI Identifier:
22645131
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 94; Journal Issue: 4; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACUTE IRRADIATION; BONE MARROW; CHEMOTHERAPY; CHILDREN; LYMPHOMAS; MULTIVARIATE ANALYSIS; PATIENTS; RADIATION DOSES; RADIATION HAZARDS; RADIOTHERAPY; SIDE EFFECTS; TOXICITY

Citation Formats

Pixberg, Caroline, Koch, Raphael, Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de, Department of Radiation Oncology, University of Koeln, Koeln, Martinsson, Ulla, Kristensen, Ingrid, Matuschek, Christiane, Kortmann, Rolf-Dieter, Pohl, Fabian, Elsayad, Khaled, Christiansen, Hans, Willich, Normann, Lindh, Jack, Steinmann, Diana, and Department of Radiation Oncology, Medical School Hannover, Hannover. Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2015.12.353.
Pixberg, Caroline, Koch, Raphael, Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de, Department of Radiation Oncology, University of Koeln, Koeln, Martinsson, Ulla, Kristensen, Ingrid, Matuschek, Christiane, Kortmann, Rolf-Dieter, Pohl, Fabian, Elsayad, Khaled, Christiansen, Hans, Willich, Normann, Lindh, Jack, Steinmann, Diana, & Department of Radiation Oncology, Medical School Hannover, Hannover. Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration. United States. doi:10.1016/J.IJROBP.2015.12.353.
Pixberg, Caroline, Koch, Raphael, Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de, Department of Radiation Oncology, University of Koeln, Koeln, Martinsson, Ulla, Kristensen, Ingrid, Matuschek, Christiane, Kortmann, Rolf-Dieter, Pohl, Fabian, Elsayad, Khaled, Christiansen, Hans, Willich, Normann, Lindh, Jack, Steinmann, Diana, and Department of Radiation Oncology, Medical School Hannover, Hannover. Tue . "Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration". United States. doi:10.1016/J.IJROBP.2015.12.353.
@article{osti_22645131,
title = {Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration},
author = {Pixberg, Caroline and Koch, Raphael and Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de and Department of Radiation Oncology, University of Koeln, Koeln and Martinsson, Ulla and Kristensen, Ingrid and Matuschek, Christiane and Kortmann, Rolf-Dieter and Pohl, Fabian and Elsayad, Khaled and Christiansen, Hans and Willich, Normann and Lindh, Jack and Steinmann, Diana and Department of Radiation Oncology, Medical School Hannover, Hannover},
abstractNote = {Purpose: In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae. Materials and Methods: Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: As of June 2013, 1500 children have been recruited into the RiSK database and 485 into the RADTOX registry leading to an analysis population of 1359 patients (age range 0-18). A total of 18.9% (n=257) of all investigated patients developed high-grade acute toxicity (grades 3/4). High-grade toxicity of the bone marrow was documented for 63.8% (n=201) of those patients, oral mucositis for 7.6% (n=24), and dermatitis for 7.6% (n=24). Patients with high-grade acute toxicity received concomitant chemotherapy more frequently (56%) than patients with no or lower acute toxicity (31.5%). In multivariate analyses, concomitant chemotherapy, diagnosis of Ewing sarcoma, and total radiation dose showed a statistically noticeable effect (P≤.05) on acute toxicity, whereas age, concomitant chemotherapy, Hodgkin lymphoma, Ewing sarcoma, total radiation dose, and acute toxicity influenced the time until maximal late toxicity. Conclusions: Generally, high-grade acute toxicity after irradiation in children and adolescence occurs in a moderate proportion of patients (18.9%). As anticipated, the probability of acute toxicity appeared to depend on the prescribed dose as well as concomitant chemotherapy. The occurrence of chronic toxicity correlates with the prior acute toxicity grade. Age seems to influence the time until maximal late toxicity but not the development of acute toxicity.},
doi = {10.1016/J.IJROBP.2015.12.353},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 94,
place = {United States},
year = {2016},
month = {3}
}