PURPOSE: To assess the effect of local radiation administered to primary disease sites in children with high-risk neuroblastoma. MATERIALS AND METHODS: A total of 539 eligible patients were entered onprotocol CCG-3891, consisting of chemotherapy, primary surgery, and 10 Gy of external beam radiation therapy (EBRT) to gross residual disease, followed by randomized assignment to continuation chemotherapy (CC) or autologous bone marrow transplantation (ABMT). ABMT patients received total body irradiation (TBI). RESULTS:Estimated event-free survival and overall survival at 5 years were 25% +/- 2% and 35% +/- 2%, respectively. Estimated 5-year locoregional recurrence rates were 51% +/- 5% and 33% +/- 7% for CC and ABMT patients (p = 0.004). For patients who received 10 Gy of EBRT to the primary, the addition of 10 Gy of TBI and ABMT decreased local recurrence compared with CC (22% +/- 12% and 52% +/- 8%, p = 0.022). EBRT did not increase acute toxicity, except for increased total parenteral nutrition administration. CONCLUSIONS: In combination with EBRT to the primary tumor site, the addition of 10 Gy of TBI as a component of high-dose chemotherapy with ABMT improved local control compared with CC without TBI. Results suggest a dose-response relationship for local EBRT. Short-term toxicity of local EBRT is limited.
RCT Entities:
PURPOSE: To assess the effect of local radiation administered to primary disease sites in children with high-risk neuroblastoma. MATERIALS AND METHODS: A total of 539 eligible patients were entered on protocol CCG-3891, consisting of chemotherapy, primary surgery, and 10 Gy of external beam radiation therapy (EBRT) to gross residual disease, followed by randomized assignment to continuation chemotherapy (CC) or autologous bone marrow transplantation (ABMT). ABMT patients received total body irradiation (TBI). RESULTS: Estimated event-free survival and overall survival at 5 years were 25% +/- 2% and 35% +/- 2%, respectively. Estimated 5-year locoregional recurrence rates were 51% +/- 5% and 33% +/- 7% for CC and ABMT patients (p = 0.004). For patients who received 10 Gy of EBRT to the primary, the addition of 10 Gy of TBI and ABMT decreased local recurrence compared with CC (22% +/- 12% and 52% +/- 8%, p = 0.022). EBRT did not increase acute toxicity, except for increased total parenteral nutrition administration. CONCLUSIONS: In combination with EBRT to the primary tumor site, the addition of 10 Gy of TBI as a component of high-dose chemotherapy with ABMT improved local control compared with CC without TBI. Results suggest a dose-response relationship for local EBRT. Short-term toxicity of local EBRT is limited.
Authors: Steve E Braunstein; Wendy B London; Susan G Kreissman; Judith G Villablanca; Andrew M Davidoff; Kenneth DeSantes; Robert P Castleberry; Kevin Murray; Lisa Diller; Katherine Matthay; Susan L Cohn; Barry Shulkin; Daniel von Allmen; Marguerite T Parisi; Collin Van Ryn; Julie R Park; Michael P La Quaglia; Daphne A Haas-Kogan Journal: Pediatr Blood Cancer Date: 2019-04-09 Impact factor: 3.167
Authors: Brian H Kushner; Stephen S Roberts; Danielle N Friedman; Deborah Kuk; Irina Ostrovnaya; Shakeel Modak; Kim Kramer; Ellen M Basu; Nai-Kong V Cheung Journal: Cancer Date: 2015-02-27 Impact factor: 6.860
Authors: Brian H Kushner; Nai-Kong V Cheung; Christopher A Barker; Kim Kramer; Shakeel Modak; Karima Yataghene; Suzanne L Wolden Journal: Int J Radiat Oncol Biol Phys Date: 2009-05-08 Impact factor: 7.038
Authors: Dana L Casey; Brian H Kushner; Nai-Kong V Cheung; Shakeel Modak; Ellen M Basu; Stephen S Roberts; Michael P LaQuaglia; Suzanne L Wolden Journal: Int J Radiat Oncol Biol Phys Date: 2019-02-11 Impact factor: 7.038
Authors: Jared R Robbins; Matthew J Krasin; Atmaram S Pai Panandiker; Amy Watkins; Jianrong Wu; Victor M Santana; Wayne L Furman; Andrew M Davidoff; Lisa M McGregor Journal: J Pediatr Surg Date: 2010-04 Impact factor: 2.545
Authors: Dana L Casey; Brian H Kushner; Nai-Kong V Cheung; Shakeel Modak; Michael P LaQuaglia; Suzanne L Wolden Journal: Int J Radiat Oncol Biol Phys Date: 2016-05-27 Impact factor: 7.038
Authors: Dana L Casey; Ken L Pitter; Brian H Kushner; Nai-Kong V Cheung; Shakeel Modak; Michael P LaQuaglia; Suzanne L Wolden Journal: Int J Radiat Oncol Biol Phys Date: 2018-01-09 Impact factor: 7.038
Authors: Brian H Kushner; Kim Kramer; Shakeel Modak; Li-Xuan Qin; Karima Yataghena; Suresh C Jhanwar; Nai-Kong V Cheung Journal: Pediatr Blood Cancer Date: 2009-07 Impact factor: 3.167