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01.07.2015 | Original Article

Long-term side effects of radiotherapy for pediatric localized neuroblastoma

Results from clinical trials NB90 and NB94

verfasst von: Anne Ducassou, M.D., Marion Gambart, M.D., Caroline Munzer, MSc.Res., Laetitia Padovani, M.D., Ph.D., Christian Carrie, M.D., Daphne Haas-Kogan, M.D., Valérie Bernier-Chastagner, M.D., Charlotte Demoor, M.D., Line Claude, M.D., Sylvie Helfre, M.D., Stéphanie Bolle, M.D., Julie Leseur, M.D., Aymeri Huchet, M.D., Hervé Rubie, M.D., Dominique Valteau-Couanet, M.D., PhD., Gudrun Schleiermacher, M.D., Ph.D., Carole Coze, M.D., Ph.D., Anne-Sophie Defachelles, M.D., Aurélien Marabelle, M.D., Stéphane Ducassou, M.D., Christine Devalck, M.D., Virginie Gandemer, M.D., Martine Munzer, M.D., Anne Laprie, M.D., PhD., On behalf of the Neuroblastoma study group and radiotherapy group of the French Society of Children with Cancer (SFCE)

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2015

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Abstract

Introduction

Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94.

Patients and methods

From 1990–2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at ≤ 2 years, 34 Gy at > 2 years, ± a 5 Gy boost in both age groups.

Results

The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5–21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy.

Conclusion

After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy.

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Titel: Long-term side effects of radiotherapy for pediatric localized neuroblastoma
Results from clinical trials NB90 and NB94
verfasst von: Anne Ducassou, M.D.
Marion Gambart, M.D.
Caroline Munzer, MSc.Res.
Laetitia Padovani, M.D., Ph.D.
Christian Carrie, M.D.
Daphne Haas-Kogan, M.D.
Valérie Bernier-Chastagner, M.D.
Charlotte Demoor, M.D.
Line Claude, M.D.
Sylvie Helfre, M.D.
Stéphanie Bolle, M.D.
Julie Leseur, M.D.
Aymeri Huchet, M.D.
Hervé Rubie, M.D.
Dominique Valteau-Couanet, M.D., PhD.
Gudrun Schleiermacher, M.D., Ph.D.
Carole Coze, M.D., Ph.D.
Anne-Sophie Defachelles, M.D.
Aurélien Marabelle, M.D.
Stéphane Ducassou, M.D.
Christine Devalck, M.D.
Virginie Gandemer, M.D.
Martine Munzer, M.D.
Anne Laprie, M.D., PhD.
On behalf of the Neuroblastoma study group and radiotherapy group of the French Society of Children with Cancer (SFCE)
Publikationsdatum: 01.07.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 7/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0837-z

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Long-term side effects of radiotherapy for pediatric localized neuroblastoma

Results from clinical trials NB90 and NB94