TY - JOUR
T1 - Long-term side effects of radiotherapy for pediatric localized neuroblastoma
T2 - Results from clinical trials NB90 and NB94
AU - Ducassou, Anne
AU - Gambart, Marion
AU - Munzer, Caroline
AU - Padovani, Laetitia
AU - Carrie, Christian
AU - Haas-Kogan, Daphne
AU - Bernier-Chastagner, Valérie
AU - Demoor, Charlotte
AU - Claude, Line
AU - Helfre, Sylvie
AU - Bolle, Stéphanie
AU - Leseur, Julie
AU - Huchet, Aymeri
AU - Rubie, Hervé
AU - Valteau-Couanet, Dominique
AU - Schleiermacher, Gudrun
AU - Coze, Carole
AU - Defachelles, Anne Sophie
AU - Marabelle, Aurélien
AU - Ducassou, Stéphane
AU - Devalck, Christine
AU - Gandemer, Virginie
AU - Munzer, Martine
AU - Laprie, Anne
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2015/7/29
Y1 - 2015/7/29
N2 - Introduction: Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94. Patients and methods: From 1990–2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at ≤ 2 years, 34 Gy at > 2 years, ± a 5 Gy boost in both age groups. Results: The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5–21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy. Conclusion: After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy.
AB - Introduction: Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94. Patients and methods: From 1990–2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at ≤ 2 years, 34 Gy at > 2 years, ± a 5 Gy boost in both age groups. Results: The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5–21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy. Conclusion: After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy.
KW - Late effects
KW - Musculoskeletal abnormalities
KW - Neoplasms, second primary
KW - Radiation therapy
KW - Scoliosis
UR - http://www.scopus.com/inward/record.url?scp=84933179260&partnerID=8YFLogxK
U2 - 10.1007/s00066-015-0837-z
DO - 10.1007/s00066-015-0837-z
M3 - Article
C2 - 25896312
AN - SCOPUS:84933179260
SN - 0179-7158
VL - 191
SP - 604
EP - 612
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 7
ER -