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Title: Combination of external-beam radiotherapy with intraoperative electron-beam therapy is effective in incompletely resected pediatric malignancies

Abstract

Purpose: Intraoperative electron-beam radiotherapy (IOERT) has been applied for local dose escalation in over 1,400 patients in Heidelberg since 1991. Among these were 30 children, in 18 of whom IOERT was employed in radiation treatment with external-beam radiotherapy (EBRT) on account of incomplete resection. We address the question whether IOERT is able to compensate for microscopic or macroscopic tumor residue if employed in the overall radiation regimen. Methods and Materials: The data of the aforementioned 18 children were analyzed with regard to local recurrence, overall survival, and complication rates. All children suffered from either sarcomas or neuroblastomas. In all children, IOERT was employed for local dose escalation after or before EBRT. Results: After a median follow-up of 60.5 months, 15 of the treated children are alive. One local failure has been observed. Six children show clinically significant late morbidity, including the loss of a treated limb (Radiation Therapy Oncology Group Grade 4 [RTOG 4]), a severe nerve lesion (RTOG 3), an orthopedic complication (RTOG 2), a ureteral stenosis (not clinically significant), and a kidney hypotrophy (not clinically significant). In 1 child a fracture due to radionecrosis (RTOG 4) was diagnosed; however, in the follow-up, local tumor relapse was diagnosed asmore » another possible reason for the fracture. Conclusions: Regarding the low incidence of local failure, IOERT seems to be able to compensate incomplete tumor resection in childhood sarcoma and neuroblastoma patients. The incidence of late morbidity is low enough to justify the employment of IOERT as part of the radiation treatment regimen for pediatric patients.« less

Authors:
 [1];  [1];  [1];  [1];  [2];  [3];  [4];  [3];  [5];  [1];  [1]
  1. Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)
  2. Department of Radiation Oncology, RWTH Aachen, Aachen (Germany)
  3. Department of Pediatric Oncology, University of Heidelberg, Heidelberg (Germany)
  4. Department of Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg (Germany)
  5. Department of Pediatric Surgery, University of Heidelberg, Heidelberg (Germany)
Publication Date:
OSTI Identifier:
20788290
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 64; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.06.038; PII: S0360-3016(05)02222-4; Copyright (c) 2006 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; BONE FRACTURES; CHILDREN; DISEASE INCIDENCE; ELECTRON BEAMS; KIDNEYS; LIMBS; PATIENTS; RADIOTHERAPY; SARCOMAS

Citation Formats

Oertel, Susanne, Niethammer, Andreas G, Krempien, Robert, Roeder, Falk, Eble, Michael J, Baer, Claudia, Huber, Peter E, Kulozik, Andreas, Waag, Karl-Ludwig, Treiber, Martina, and Debus, Juergen. Combination of external-beam radiotherapy with intraoperative electron-beam therapy is effective in incompletely resected pediatric malignancies. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Oertel, Susanne, Niethammer, Andreas G, Krempien, Robert, Roeder, Falk, Eble, Michael J, Baer, Claudia, Huber, Peter E, Kulozik, Andreas, Waag, Karl-Ludwig, Treiber, Martina, & Debus, Juergen. Combination of external-beam radiotherapy with intraoperative electron-beam therapy is effective in incompletely resected pediatric malignancies. United States. https://doi.org/10.1016/J.IJROBP.2005.0
Oertel, Susanne, Niethammer, Andreas G, Krempien, Robert, Roeder, Falk, Eble, Michael J, Baer, Claudia, Huber, Peter E, Kulozik, Andreas, Waag, Karl-Ludwig, Treiber, Martina, and Debus, Juergen. 2006. "Combination of external-beam radiotherapy with intraoperative electron-beam therapy is effective in incompletely resected pediatric malignancies". United States. https://doi.org/10.1016/J.IJROBP.2005.0.
@article{osti_20788290,
title = {Combination of external-beam radiotherapy with intraoperative electron-beam therapy is effective in incompletely resected pediatric malignancies},
author = {Oertel, Susanne and Niethammer, Andreas G and Krempien, Robert and Roeder, Falk and Eble, Michael J and Baer, Claudia and Huber, Peter E and Kulozik, Andreas and Waag, Karl-Ludwig and Treiber, Martina and Debus, Juergen},
abstractNote = {Purpose: Intraoperative electron-beam radiotherapy (IOERT) has been applied for local dose escalation in over 1,400 patients in Heidelberg since 1991. Among these were 30 children, in 18 of whom IOERT was employed in radiation treatment with external-beam radiotherapy (EBRT) on account of incomplete resection. We address the question whether IOERT is able to compensate for microscopic or macroscopic tumor residue if employed in the overall radiation regimen. Methods and Materials: The data of the aforementioned 18 children were analyzed with regard to local recurrence, overall survival, and complication rates. All children suffered from either sarcomas or neuroblastomas. In all children, IOERT was employed for local dose escalation after or before EBRT. Results: After a median follow-up of 60.5 months, 15 of the treated children are alive. One local failure has been observed. Six children show clinically significant late morbidity, including the loss of a treated limb (Radiation Therapy Oncology Group Grade 4 [RTOG 4]), a severe nerve lesion (RTOG 3), an orthopedic complication (RTOG 2), a ureteral stenosis (not clinically significant), and a kidney hypotrophy (not clinically significant). In 1 child a fracture due to radionecrosis (RTOG 4) was diagnosed; however, in the follow-up, local tumor relapse was diagnosed as another possible reason for the fracture. Conclusions: Regarding the low incidence of local failure, IOERT seems to be able to compensate incomplete tumor resection in childhood sarcoma and neuroblastoma patients. The incidence of late morbidity is low enough to justify the employment of IOERT as part of the radiation treatment regimen for pediatric patients.},
doi = {10.1016/J.IJROBP.2005.0},
url = {https://www.osti.gov/biblio/20788290}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 64,
place = {United States},
year = {Sun Jan 01 00:00:00 EST 2006},
month = {Sun Jan 01 00:00:00 EST 2006}
}