Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology
- Department of Radiation Oncology, Centre Leon Berard, Lyon (France)
- Department of Pediatrics, Institut Gustave Roussy, Villejuif (France)
- Department of Pediatrics, Institut Curie, Paris (France)
- Mater Hospitals, Brisbane (Australia)
- Department of Pediatrics, Hopital La Timone, Marseille (France)
- Department of Pediatrics, Hopital Nord C.H.U. Saint Etienne, Saint Priest-En-Jarez (France)
- Department of Pediatrics, Centre Leon Berard, Lyon (France)
Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma.
- OSTI ID:
- 20793428
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 64, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2005.10.020; PII: S0360-3016(05)02832-4; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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