Derek S Tsang1,2, Carol Oliveira3, Eric Bouffet2, Cynthia Hawkins4, Vijay Ramaswamy2, Ryan Yee1, Uri Tabori2, Ute Bartels2, Annie Huang2, Barbara-Ann Millar1, Bruce Crooks5, Lynette Bowes6, Shayna Zelcer7, Normand Laperriere1,2. 1. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 2. Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. 3. Division of Radiation Oncology, Queen's University, Kingston, Ontario, Canada. 4. Paediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. 5. Division of Hematology-Oncology, IWK Health Centre, Halifax, Nova Scotia, Canada. 6. Janeway Child Health Centre, St. John's, Newfoundland, Canada. 7. London Health Sciences Centre, London, Ontario, Canada.
Abstract
BACKGROUND: There are very few studies about the role of repeat irradiation (RT2) for children with recurrent supratentorial high-grade glioma (HGG). It was the aim of this study to assess the effectiveness and safety of RT2 in this population. PROCEDURE: This was a retrospective cohort study of 40 children age 18 years and under with recurrent supratentorial HGG who had received at least one course of RT. In-field reirradiation volumes included focal or whole brain RT, with doses ranging from 30 to 54 Gy. The primary endpoint was overall survival (OS) from the first day of RT2. RESULTS: Fourteen patients underwent RT2. The median survival of these patients was 6.5 months. Patients with ≥12 months elapsed time between RT1 and RT2 experienced longer OS than patients who had < 12 months (P = 0.009). There was no difference in OS between patients with or without germline mutations (e.g., Lynch, Li-Fraumeni, or constitutional mismatch-repair deficiency, P = 0.20). Ten patients received RT2 that overlapped with RT1 volumes for locally recurrent disease. Of this group, 80% experienced clinical benefit from in-field RT2, defined as clinical/radiologic response or stable disease. Ninety-three percent completed the prescribed course of RT2, with one patient developing grade 3 radiation necrosis four months after RT2. When compared with 26 patients who were not offered reirradiation, those selected for RT2 had improved median survival from the time of first disease progression (9.4 vs 3.8 months, P = 0.005). CONCLUSIONS: Reirradiation for children with recurrent supratentorial HGG is a safe, effective treatment that provides short-term disease control.
BACKGROUND: There are very few studies about the role of repeat irradiation (RT2) for children with recurrent supratentorial high-grade glioma (HGG). It was the aim of this study to assess the effectiveness and safety of RT2 in this population. PROCEDURE: This was a retrospective cohort study of 40 children age 18 years and under with recurrent supratentorial HGG who had received at least one course of RT. In-field reirradiation volumes included focal or whole brain RT, with doses ranging from 30 to 54 Gy. The primary endpoint was overall survival (OS) from the first day of RT2. RESULTS: Fourteen patients underwent RT2. The median survival of these patients was 6.5 months. Patients with ≥12 months elapsed time between RT1 and RT2 experienced longer OS than patients who had < 12 months (P = 0.009). There was no difference in OS between patients with or without germline mutations (e.g., Lynch, Li-Fraumeni, or constitutional mismatch-repair deficiency, P = 0.20). Ten patients received RT2 that overlapped with RT1 volumes for locally recurrent disease. Of this group, 80% experienced clinical benefit from in-field RT2, defined as clinical/radiologic response or stable disease. Ninety-three percent completed the prescribed course of RT2, with one patient developing grade 3 radiation necrosis four months after RT2. When compared with 26 patients who were not offered reirradiation, those selected for RT2 had improved median survival from the time of first disease progression (9.4 vs 3.8 months, P = 0.005). CONCLUSIONS: Reirradiation for children with recurrent supratentorial HGG is a safe, effective treatment that provides short-term disease control.
Authors: Erin E Crotty; Sarah E S Leary; J Russell Geyer; James M Olson; Nathan E Millard; Aimee A Sato; Ralph P Ermoian; Bonnie L Cole; Christina M Lockwood; Vera A Paulson; Samuel R Browd; Richard G Ellenbogen; Jason S Hauptman; Amy Lee; Jeffrey G Ojemann; Nicholas A Vitanza Journal: J Neurooncol Date: 2020-06-16 Impact factor: 4.130
Authors: Kathrine S Rallis; Alan Mathew George; Anna Maria Wozniak; Carola Maria Bigogno; Barbara Chow; John Gerrard Hanrahan; Michail Sideris Journal: Cancer Genomics Proteomics Date: 2022 Jul-Aug Impact factor: 3.395