Elisa Zambaiti1, Alexander Siles Hinojosa2, Valentina Montano3, Annika Mutanen4, Mathilde Glenisson5, Sabine Sarnacki6, Stephanie Franchi Abella7, Daniele Pariente7, Luca Pio6. 1. Department of Women's and Children's Health, Pediatric Surgery, Universita degli Studi di Padova Dipartimento di Medicina, Padova, Italy. 2. Pediatric Surgery Department, Miguel Servet University Hospital, Zaragoza, Spain. 3. Depatment Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada. 5. Department of Pediatric Surgery and Urology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Pari (AP-HP), Paris, France. 6. Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Descartes University, Université de Paris, Paris, France. 7. Pediatric Radiology Department, Assistance Publique-Hôpitaux de Pari (AP-HP), Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Abstract
INTRODUCTION: The use of interventional radiology (IR) in the treatment of pediatric solid tumors has markedly increased over the last three decades. However, data on effectiveness of IR-techniques, such as embolization/ablation, are scarce. In this systematic review and meta-analysis, we examined the outcomes of IR-procedures in the treatment of solid tumors in children. MATERIALS AND METHODS: Using a defined search strategy, we searched for studies reporting the use of IR-techniques for pediatric solid tumors from 1980 to 2017. Reports with less than three patients, review, and opinion articles were excluded. The study was conducted under preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We analyzed dichotomous and continuous variables by appropriate statistical methods. RESULTS: Of 567 articles screened, 21 papers met the inclusion criteria (12 retrospective, 7 prospective, and 2 randomized-control trials). Many of the analyzed papers described relatively small cohorts of patients. IR-guided procedures were mainly rescue procedures to treat primarily unresectable tumors, local recurrences, or metastases. Inclusion/exclusion criteria and success definition were not specified in most reports. Major side effects were documented in 17/286 (6%) infants, while minor side effects were self-limiting in most patients. Six studies had a comparison between tumor embolization (127 infants) to surgery or chemotherapy without IR-procedures (113 controls). The meta-analysis showed lower mortality (16 vs. 47%) and surgical time for resection (206 vs. 250 m), higher 2-year tumor-free survival (82 vs. 36%), and favorable histology in IR group (p < 0.001 for all). CONCLUSION: IR-guided techniques are promising in the treatment of pediatric solid tumors. Further prospective (randomized) trials are needed to clarify efficacy. Georg Thieme Verlag KG Stuttgart · New York.
INTRODUCTION: The use of interventional radiology (IR) in the treatment of pediatric solid tumors has markedly increased over the last three decades. However, data on effectiveness of IR-techniques, such as embolization/ablation, are scarce. In this systematic review and meta-analysis, we examined the outcomes of IR-procedures in the treatment of solid tumors in children. MATERIALS AND METHODS: Using a defined search strategy, we searched for studies reporting the use of IR-techniques for pediatric solid tumors from 1980 to 2017. Reports with less than three patients, review, and opinion articles were excluded. The study was conducted under preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We analyzed dichotomous and continuous variables by appropriate statistical methods. RESULTS: Of 567 articles screened, 21 papers met the inclusion criteria (12 retrospective, 7 prospective, and 2 randomized-control trials). Many of the analyzed papers described relatively small cohorts of patients. IR-guided procedures were mainly rescue procedures to treat primarily unresectable tumors, local recurrences, or metastases. Inclusion/exclusion criteria and success definition were not specified in most reports. Major side effects were documented in 17/286 (6%) infants, while minor side effects were self-limiting in most patients. Six studies had a comparison between tumor embolization (127 infants) to surgery or chemotherapy without IR-procedures (113 controls). The meta-analysis showed lower mortality (16 vs. 47%) and surgical time for resection (206 vs. 250 m), higher 2-year tumor-free survival (82 vs. 36%), and favorable histology in IR group (p < 0.001 for all). CONCLUSION: IR-guided techniques are promising in the treatment of pediatric solid tumors. Further prospective (randomized) trials are needed to clarify efficacy. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
Authors: Sophie Bockhold; Shane J Foley; Louise A Rainford; Riccardo Corridori; Annika Eberstein; Christoph Hoeschen; Mark W Konijnenberg; Susan Molyneux-Hodgson; Graciano Paulo; Joana Santos; Jonathan P McNulty Journal: J Transl Med Date: 2022-03-18 Impact factor: 5.531