Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma

Journal Article · Sat Oct 01 04:00:00 EDT 2016 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2016.05.020· OSTI ID:22645656

Casey, Dana L. ^[1]; Kushner, Brian H.; Cheung, Nai-Kong V.; Modak, Shakeel ^[2]; LaQuaglia, Michael P. ^[3]

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1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)
2. Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York (United States)
3. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

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.

• OSTI ID: 22645656
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 96; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
GY RANGE 01-10
GY RANGE 10-100
LACTATE DEHYDROGENASE
PATIENTS
RADIATION HAZARDS
RADIOTHERAPY