Long-term Side Effects of Radiotherapy for Pediatric Localized Neuroblastoma : Results from Clinical Trials NB90 and NB94

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2015 Apr 22

PMID 25896312

Citations 16

Authors

Anne Ducassou

Marion Gambart

Caroline Munzer

Laetitia Padovani

Christian Carrie

Daphne Haas-Kogan

Valerie Bernier-Chastagner

Charlotte Demoor

Line Claude

Sylvie Helfre

Stephanie Bolle

Julie Leseur

Aymeri Huchet

Herve Rubie

Dominique Valteau-Couanet

Gudrun Schleiermacher

Carole Coze

Anne-Sophie Defachelles

Aurelien Marabelle

Stephane Ducassou

Christine Devalck

Virginie Gandemer

Martine Munzer

Anne Laprie

Affiliations

Soon will be listed here.

Abstract

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.

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