Proton Beam Therapy for Children With Neuroblastoma: Experiences From the Prospective KiProReg Registry.
Proton Beam Therapy for Children With Neuroblastoma: Experiences From the Prospective KiProReg Registry.
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质子束治疗儿童神经母细胞瘤：来自前瞻性 KiProReg 登记处的经验。
DOI：
10.3389/fonc.2020.617506
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发表时间：
2020
影响因子：
4.7
通讯作者：
Timmermann B
中科院分区：
文献类型：
--
作者：
Jazmati D;Butzer S;Hero B;Ahmad Khalil D;Merta J;Bäumer C;Plum G;Fuchs J;Koerber F;Steinmeier T;Peters S;Doyen J;Thole T;Schmidt M;Blase C;Tippelt S;Eggert A;Schwarz R;Simon T;Timmermann B
放射治疗(RT)是高危神经母细胞瘤(NB)跨学科治疗的重要组成部分。随着结果的不断改善，人们对局部治疗策略的兴趣与日俱增，这些策略在减少治疗相关副作用的同时获得最佳的肿瘤学结果。在减轻治疗负担方面，质子束治疗(PBT)是一种很有前途的替代传统光子照射的方法。对2015-2020年间在一线治疗期间接受原发肿瘤部位PBT治疗的高危或中危NB儿童进行了回顾性分析。分析了来自前瞻性内部登记标准ProtonenTreatie WPE-Kinder-(KiProReg)的关于肿瘤控制和治疗毒性的数据。不良事件按PBT前、中、后的CTCAE版本4(V4.0)进行分类。共有44例(男24例，女20例)高危(n=39)或中危(n=5)NB患者进入分析。中位年龄3.4岁(1.4~9.9岁)。PBT剂量范围为21.0~39.6Gray，中位数为36.0Gy.根据NB-2004方案，5名患者在PBT时接受了原发肿瘤部位的MIBG-Avid残留的PBT。在39例患者中，术前肿瘤床接受放射治疗，如果有残留肿瘤，则给予或不给予额外的助力。中位随访(FU)27.6个月后，8名患者进展，局部复发(1例)或远处转移(7例)。4名患者死于肿瘤进展。3年局部控制率、无远处转移生存率、无进展生存率和总生存率分别为97.7%、84.1%、81.8%和90.9%。在放射治疗期间，7名患者出现较高级别(CTCAE≥°3)的血液学毒性。未发生其他较高级别的急性毒性反应。PBT后，一名患者在接受免疫治疗时出现一过性脊髓炎。到目前为止，没有观察到较高级别的长期毒性。PBT是一种耐受性良好且有效的局部治疗方法，适用于高危和中危NB儿童。RT在强化多学科治疗方案中的作用仍有待于未来的研究，以便更好地确定在特别敏感的患者队列中进行RT的时机、剂量、靶量和一般需求。
Radiotherapy (RT) is an integral part of the interdisciplinary treatment of patients with high-risk neuroblastoma (NB). With the continuous improvements of outcome, the interest in local treatment strategies that reduce treatment-related side effects while achieving optimal oncological results is growing. Proton beam therapy (PBT) represents a promising alternative to conventional photon irradiation with regard to the reduction of treatment burden. Retrospective analysis of children with high or intermediate risk NB receiving PBT of the primary tumor site during first-line therapy between 2015 and 2020 was performed. Data from the prospective in-house registry Standard Protonentherapie WPE – Kinder- (KiProReg) with respect to tumor control and treatment toxicity were analyzed. Adverse events were classified according to CTCAE Version 4 (V4.0) before, during, and after PBT. In total, 44 patients (24 male, 20 female) with high (n = 39) or intermediate risk NB (n = 5) were included in the analysis. Median age was 3.4 years (range, 1.4–9.9 years). PBT doses ranged from 21.0 to 39.6 Gray (Gy) (median 36.0 Gy). Five patients received PBT to the MIBG-avid residual at the primary tumor site at time of PBT according to the NB-2004 protocol. In 39 patients radiation was given to the pre-operative tumor bed with or without an additional boost in case of residual tumor. After a median follow-up (FU) of 27.6 months, eight patients developed progression, either local recurrence (n = 1) or distant metastases (n = 7). Four patients died due to tumor progression. At three years, the estimated local control, distant metastatic free survival, progression free survival, and overall survival was 97.7, 84.1, 81.8, and 90.9%, respectively. During radiation, seven patients experienced higher-grade (CTCAE ≥ °3) hematologic toxicity. No other higher grade acute toxicity occurred. After PBT, one patient developed transient myelitis while receiving immunotherapy. No higher grade long-term toxicity was observed up to date. PBT was a well tolerated and effective local treatment in children with high and intermediate risk NB. The role of RT in an intensive multidisciplinary treatment regimen remains to be studied in the future in order to better define timing, doses, target volumes, and general need for RT in a particularly sensitive cohort of patients.
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影响因子：
5.4
作者：
Huang M;Weiss WA
通讯作者：
Weiss WA
影响因子：
50.5
作者：
Berthold, F.;Faldum, A.;Simon, T.
通讯作者：
Simon, T.
影响因子：
51.1
作者：
Berthold, F;Boos, J;Hero, B
通讯作者：
Hero, B
DOI：
10.1016/j.ijrobp.2016.11.043
发表时间：
2017-03-15
影响因子：
7
作者：
Ferris, Matthew J.;Danish, Hasan;Esiashvili, Natia
通讯作者：
Esiashvili, Natia
DOI：
10.1016/j.ijrobp.2007.04.006
发表时间：
2007-11-01
影响因子：
7
作者：
Gillis, Amy M.;Sutton, Elizabeth;Haas-Kogan, Daphne
通讯作者：
Haas-Kogan, Daphne