Clinical outcomes and efficacy of stereotactic body radiation therapy in children, adolescents, and young adults with metastatic solid tumors.

Autor: Baliga S; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA., Matsui J; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA., Klamer B; Department of Biomedical Informatics, College of Medicine at the Ohio State University, Columbus, OH, USA., Cetnar A; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA., Ewing A; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA., Cadieux C; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA., Gupta A; Division of Hematology/Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA., Setty BA; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA., Roberts RD; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA., Olshefski RS; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA., Cripe TP; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA., Scharschmidt TJ; Division of Pediatric Orthopedic Oncology, Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA., Aldrink J; Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA., Mardis E; The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, OH, USA., Yeager ND; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA., Palmer JD; Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.; Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA.
Jazyk: angličtina
Zdroj: The British journal of radiology [Br J Radiol] 2022 May 01; Vol. 95 (1133), pp. 20211088. Date of Electronic Publication: 2022 Feb 10.
DOI: 10.1259/bjr.20211088
Abstrakt: Objective: The objective of this study is to report disease outcomes and toxicity with the use of stereotactic body radiation therapy (SBRT) in the treatment of pediatric metastatic disease.
Methods: All pediatric and adolescent young adult (AYA) patients' who received SBRT were included between the years 2000 and 2020. Study endpoints included local control (LC), progression-free survival (PFS), overall survival (OS), cumulative incidence (CI) of death or local failure and toxicity. The end points with respect to survival and LC were calculated using the Kaplan-Meier estimate. The cumulative incidence of local failure was calculated using death as a competing risk.
Results: 16 patients with 36 lesions irradiated met inclusion criteria and formed the study cohort. The median OS and PFS for the entire cohort were 17 months and 15.7 months, respectively. The 1 year OS for the entire cohort was 75%. The 6- and 12 month local control was 85 and 78%, respectively. There were no local failures in irradiated lesions for patients who received a BED 10 ≥100 Gy. Patients who were treated with SBRT who had ≤5 metastatic lesions at first recurrence had a superior 1 year OS of 100  vs 50% for those with >5 lesions. One patient (6.3%) experienced a Grade 3 central nervous system toxicity.
Conclusion: LC was excellent with SBRT delivered to metastatic disease, particularly for lesions receiving a BED 10 ≥100 Gy. High-grade toxicity was rare in our patient population. Patients with five or fewer metastatic sites have a significantly better OS compared to >5 sites.
Advances in Knowledge: This study demonstrates that SBRT is safe and efficacious in the treatment of pediatric oligometastatic disease.
Databáze: MEDLINE