Focal versus craniospinal radiation for disseminated atypical teratoid/rhabdoid tumor following favorable response to systemic therapy.

Autor: Aridgides PD; Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York, USA., Mahajan A; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Eaton B; Department of Radiation Oncology, Winship Cancer Institute, Atlanta, Georgia, USA., Wang D; Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, New York, USA., Timmerman B; Department of Radiation Oncology, Essen University Hospital, Essen, Germany., Früwald MC; Department of Paediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany., Nemes K; Department of Paediatric and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany., Deck J; Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York, USA., Yamasaki K; Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan., Von Hoff K; Department of Pediatric Oncology and Hematology, Charite University Berlin, Berlin, Germany., Lafay-Cousin L; Section of Pediatric Oncology and Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada., Reddy A; Departments of Neurology and Pediatrics, University of California, San Francisco, California, USA., Lo AC; Department of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2023 Jul; Vol. 70 (7), pp. e30351. Date of Electronic Publication: 2023 Apr 18.
DOI: 10.1002/pbc.30351
Abstrakt: Purpose: Radiotherapy (RT) is associated with improved survival in atypical teratoid/rhabdoid tumor (ATRT); however, optimal RT delivery is unknown. A meta-analysis was conducted for disseminated (M+) ATRT receiving focal or craniospinal radiation (CSI).
Methods: After abstract screening, 25 studies (1995-2020) contained necessary patient, disease, and radiation treatment information (N = 96). All abstract, full text, and data capture were independently double-reviewed. The corresponding author was contacted for cases of insufficient information. Response to pre-radiation chemotherapy (N = 57) was categorized as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Univariate and multivariate statistics were performed to investigate survival correlation. Patients with M4 disease were excluded.
Results: The 2- and 4-year overall survival (OS) was 63.8% and 45.7%, respectively, with a median follow-up of 2 years (range 0.3-13.5). The median age was 2 years (range 0.2-19.5), and 96% received chemotherapy. On univariate analysis, gross total resection (GTR, p = .0007), pre-radiation chemotherapy response (p < .001), and high-dose chemotherapy with stem cell recuse (HDSCT, p = .002) correlated with survival. On multivariate analysis, pre-radiation chemotherapy response (p = .02) and GTR (p = .012) retained survival significance as compared to a trend for HDSCT (p = .072). Comparisons of focal RT (vs. CSI) and greater than or equal to 5400 cGy primary dose were nonsignificant. Following CR or PR, a statistical trend favored focal radiation (p = .089) over CSI.
Conclusion: Chemotherapy response prior to RT and GTR correlated with improved survival on multivariate analysis for ATRT M+ receiving RT. No benefit was observed for CSI compared to focal RT among all patients and following favorable chemotherapy response, inviting further study of focal RT for ATRT M+.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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