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

Casey, Dana L.; Kushner, Brian H.; Cheung, Nai-Kong V.; Modak, Shakeel; LaQuaglia, Michael P.

doi:10.1016/J.IJROBP.2016.05.020

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

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Abstract

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 localmore »« less

Authors:

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

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

Publication Date:: Sat Oct 01 00:00:00 EDT 2016

OSTI Identifier:: 22645656

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 96; Journal Issue: 2; 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; CHEMOTHERAPY; GY RANGE 01-10; GY RANGE 10-100; LACTATE DEHYDROGENASE; PATIENTS; RADIATION HAZARDS; RADIOTHERAPY

Citation Formats


                    Casey, Dana L., Kushner, Brian H., Cheung, Nai-Kong V., Modak, Shakeel, LaQuaglia, Michael P., and Wolden, Suzanne L., E-mail: woldens@mskcc.org. Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma.  United States: N. p., 2016. 
        Web.  doi:10.1016/J.IJROBP.2016.05.020.

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                    Casey, Dana L., Kushner, Brian H., Cheung, Nai-Kong V., Modak, Shakeel, LaQuaglia, Michael P., & Wolden, Suzanne L., E-mail: woldens@mskcc.org. Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma.  United States.  https://doi.org/10.1016/J.IJROBP.2016.05.020

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                    Casey, Dana L., Kushner, Brian H., Cheung, Nai-Kong V., Modak, Shakeel, LaQuaglia, Michael P., and Wolden, Suzanne L., E-mail: woldens@mskcc.org. 2016.  
        "Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma".  United States.  https://doi.org/10.1016/J.IJROBP.2016.05.020.

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@article{osti_22645656,

  title        = {Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma},

  author       = {Casey, Dana L. and Kushner, Brian H. and Cheung, Nai-Kong V. and Modak, Shakeel and LaQuaglia, Michael P. and Wolden, Suzanne L., E-mail: woldens@mskcc.org},

  abstractNote = {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.},

  doi          = {10.1016/J.IJROBP.2016.05.020},

  url          = {https://www.osti.gov/biblio/22645656},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 2,

  volume       = 96,

  place        = {United States},

  year         = {Sat Oct 01 00:00:00 EDT 2016},

  month        = {Sat Oct 01 00:00:00 EDT 2016}

}

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