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Titolo:
Hyperfractionated low-dose radiotherapy for high-risk neuroblastoma after intensive chemotherapy and surgery
Autore:
Kushner, BH; Wolden, S; LaQuaglia, MP; Kramer, K; Verbel, D; Heller, G; Cheung, NKV;
Indirizzi:
Mem Sloan Kettering Canc Ctr, Dept Pediat, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10021USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021USA Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 11, volume: 19, anno: 2001,
pagine: 2821 - 2828
SICI:
0732-183X(20010601)19:11<2821:HLRFHN>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; TOTAL-BODY IRRADIATION; ADVANCED NEURO-BLASTOMA; CHILDRENS-CANCER-GROUP; RADIATION-THERAPY; STAGE-4 NEUROBLASTOMA; I-131 METAIODOBENZYLGUANIDINE; COMBINATION CHEMOTHERAPY; REFRACTORY NEUROBLASTOMA; MYELOABLATIVE THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
54
Recensione:
Indirizzi per estratti:
Indirizzo: Kushner, BH Mem Sloan Kettering Canc Ctr, Dept Pediat, 1275 York Ave, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr 1275 York Ave New York NY USA 10021
Citazione:
B.H. Kushner et al., "Hyperfractionated low-dose radiotherapy for high-risk neuroblastoma after intensive chemotherapy and surgery", J CL ONCOL, 19(11), 2001, pp. 2821-2828

Abstract

Purpose: To assess prognostic factors for local control in high-risk neuroblastoma patients treated with hyperfractionated 21-Gy total dose to consolidate remission achieved by dose-intensive chemotherapy and surgery. Patients and Methods: Patients with high-risk neuroblastoma in first remission received local radiotherapy (RT) totaling 21 Gy in twice-daily 1.5-Gy fractions. RT to the primary site followed dose-intensive chemotherapy and tumor resection; the target field encompassed the extent of tumor at diagnosis, plus 3-cm margins and regional lymph nodes. RT to distant sites followed radiologic evidence of response. Local failure wets correlated with clinical factors (including other consolidative treatments) and biologic findings. Results: Of 99 consecutively irradiated patients followed for a median of 21.1 months from PT, 10 relapsed in or at margins of PT fields at 1 to 27 months (median, 14 months). At 36 months after RT, the probability of primary-site failure was 10.1% +/- 5.3%. No primary-site relapses occurred among the 23 patients whose tumors were excised at diagnosis, but there were three such relapses among the seven patients who were irradiated with evidence of residual disease in the primary site. Four of 18 patients with MYCN-amplified disease and serum lactate dehydrogenase greater than 1,500 U/L had local failures (23.4% +/- 10.7% risk at 18 months). Acute radiotoxicities were insignificant, but three of 35 patients followed for greater than or equal to 36 months had short stature from decreased growth of irradiated vertebra. Conclusion: Hyperfractionated 21-Gy PT is well tolerated and, together with dose-intensive chemotherapy and surgery, may help in local control of high-risk neuroblastoma. Extending the PT field to definitively encompass regional nodal groups may improve results. Visible residual disease may warranthigher PT dosing. Patients with biologically unfavorable disease may be atincreased risk for local failure. PT to the primary rite may not be necessary when rumors are excised at diagnosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 19:06:58