Long-term outcome and toxicities of intraoperative radiotherapy for high-risk neuroblastoma
Long-term outcome and toxicities of intraoperative radiotherapy for high-risk neuroblastoma
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DOI：
10.1016/j.ijrobp.2007.04.006
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发表时间：
2007-11-01
影响因子：
7
通讯作者：
Haas-Kogan, Daphne
中科院分区：
文献类型：
--
作者：
Gillis, Amy M.;Sutton, Elizabeth;Haas-Kogan, Daphne
目的：回顾一个历史队列的连续累积的高风险神经母细胞瘤患者术中放疗（IORT）治疗，以确定这种treatment.Methods和材料的治疗效果和晚期并发症：在1986年和2002年之间，31例新诊断的高风险神经母细胞瘤与IORT治疗的一部分，多模式治疗。他们的医疗记录进行了审查，以确定结果和并发症。Kaplan-Meier概率估计的局部控制，无进展生存，总生存率在36个月后诊断recorded.Results：术中放疗的原发部位和相关的淋巴结达到了良好的局部控制，中位随访时间为44个月。3年局部复发率估计为15%，低于大多数以前发表的系列。22例接受大体全切除的患者中只有1例在原发肿瘤部位复发。局部控制、无进展生存和总生存的3年估计值分别为85%、47%和60%。在7例发生高血压或血管狭窄的患者中观察到归因于疾病过程或多模态治疗的副作用。这些晚期并发症导致2例patients.Conclusions死亡：术中放疗时，原发性切除术提供了有效的局部控制高危神经母细胞瘤患者。与历史对照组相比，IORT取得了相当的控制率和生存率，同时避免了许多与幼儿外照射放疗相关的副作用。虽然观察到并发症，但需要进行额外的分析，以确定疾病过程和多模式治疗的特定组成部分对这些不良事件的相对贡献。(C)2007爱思唯尔公司
Purpose: To review a historical cohort of consecutively accrued patients with high-risk neuroblastoma treated with intraoperative radiotherapy (IORT) to determine the therapeutic effect and late complications of this treatment.Methods and Materials: Between 1986 and 2002, 31 patients with newly diagnosed high-risk neuroblastoma were treated with IORT as part of multimodality therapy. Their medical records were reviewed to determine the outcome and complications. Kaplan-Meier probability estimates of local control, progression-free survival, and overall survival at 36 months after diagnosis were recorded.Results: Intraoperative radiotherapy to the primary site and associated lymph nodes achieved excellent local control at a median follow-up of 44 months. The 3-year estimate of the local recurrence rate was 15%, less than that of most previously published series. Only I of 22 patients who had undergone gross total resection developed recurrence at the primary tumor site. The 3-year estimate of local control, progression-free survival, and overall survival was 85%, 47%, and 60%, respectively. Side effects attributable to either the disease process or multimodality treatment were observed in 7 patients who developed either hypertension or vascular stenosis. These late complications resulted in the death of 2 patients.Conclusions: Intraoperative radiotherapy at the time of primary resection offers effective local control in patients with high-risk neuroblastoma. Compared with historical controls, IORT achieved comparable control and survival rates while avoiding many side effects associated with external beam radiotherapy in young children. Although complications were observed, additional analysis is needed to determine the relative contributions of the disease process and specific components of the multimodality treatment to these adverse events. (C) 2007 Elsevier Inc.