Local Control and Clinical Outcome of High-risk Pediatric Neuroblastoma Patients after Receiving Multimodality Treatment and Helical Tomotherapy
Journal
Anticancer Research
Journal Volume
39
Journal Issue
4
Pages
2207-2215
Date Issued
2019
Author(s)
Abstract
Background/Aim: The local control and clinical outcome of pediatric patients with high-risk neuroblastoma treated with tomotherapy as part of a modern multimodality paradigm was assessed. Patients and Methods: Twenty-four high-risk neuroblastoma patients who received radiotherapy (RT) to the primary site using helical tomotherapy (median 21.6 Gy) were included. Local failure (LF) was correlated with biological and clinical prognostic factors. Event-free survival (EFS) and overall survival (OS) were estimated using Kaplan-Meier analysis. Results: After a median followup of 43.5 months, the 3-year cumulative incidence of LF, EFS, and OS were 21.1%, 45.8%, and 62.9%, respectively. Elevated serum lactate dehydrogenase ?1,500 U/l was associated with worse LF (p=0.02). There was no 3-year LF noted for patients with gross residual disease (GRD) who received more than 21.6 Gy. Conclusion: We demonstrated favorable local control of tomotherapy for the treatment of high-risk neuroblastoma. Dose escalation of RT for patients with GRD should be investigated. ? 2019 International Institute of Anticancer Research. All rights reserved.
SDGs
Other Subjects
lactate dehydrogenase; antineoplastic agent; lactate dehydrogenase; adolescent; Article; child; clinical article; clinical outcome; dermatitis; distant metastasis; event free survival; female; follow up; growth inhibition; high risk patient; histopathology; human; lactate dehydrogenase blood level; lymph node dissection; male; minimal residual disease; nausea and vomiting; neuroblastoma; neutropenia; overall survival; primary tumor; priority journal; radiation dose; thrombocytopenia; tomotherapy; treatment interruption; tumor recurrence; blood; hematopoietic stem cell transplantation; infant; intensity modulated radiation therapy; Kaplan Meier method; multimodality cancer therapy; neuroblastoma; preschool child; prognosis; risk; treatment outcome; Adolescent; Antineoplastic Agents; Child; Child, Preschool; Combined Modality Therapy; Female; Hematopoietic Stem Cell Transplantation; Humans; Infant; Kaplan-Meier Estimate; L-Lactate Dehydrogenase; Male; Neuroblastoma; Prognosis; Radiotherapy, Intensity-Modulated; Risk; Treatment Outcome
Publisher
International Institute of Anticancer Research
Type
journal article