Helical tomotherapy craniospinal irradiation in primary brain tumours: Toxicities and outcomes in a peadiatric and adult population.

Autor:	Savagner J; Department of Paediatric Neurology, Children's Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France., Ducassou A; Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France., Cabarrou B; Department of Biostatistics, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France., Hangard G; Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France., Gambart M; Department of Paediatric Oncology, Children's Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France., Bertozzi AI; Department of Paediatric Oncology, Children's Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France., Baudou E; Department of Paediatric Neurology, Children's Hospital of Toulouse, 330 Avenue de Grande Bretagne, 31300 Toulouse, France., Boetto S; Department of Neurosurgery, Toulouse University Hospital, Pierre-Paul Riquet Hospital, Place du Docteur Baylac, Toulouse, France., Larrieu D; Department of Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France., Laprie A; Department of Radiation Oncology, Toulouse Cancer Institute (IUCT), 1 avenue Irene Joliot-Curie, 31100 Toulouse, France.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2024 Apr 06; Vol. 46, pp. 100777. Date of Electronic Publication: 2024 Apr 06 (Print Publication: 2024).
DOI:	10.1016/j.ctro.2024.100777
Abstrakt:	Objective: As craniospinal irradiation (CSI) is delivered more frequently by helical tomotherapy (HT) with few reports about late effects, we analysed all patients treated in our centre over an 11-year period. Methods and Materials: Our study included all patients that underwent CSI by HT, between September 2009 and January 2020, in the Department of Radiation Oncology of the Toulouse Cancer Institute. Acute radiotherapy toxicities were reported and medium- to long-term outcomes analysed. Results: Among the 79 patients included, 70.9 % were younger than 18 years at diagnosis, the median age was 13 (range: 1-52) at the time of radiation therapy, 67.1 % of patients had medulloblastoma. Half of them (49.4 %) had a metastatic disease at diagnosis. The median dose of CSI was 36 Gy (range, 18-36). Seventy-seven patients received a radiation boost to the original location of the primary tumour (97.5 %), 32 patients also received a boost to their metastatic sites (40.5 %). Median follow-up was 55.5 months (95 %CI = [41.2; 71.8]). The 3-year event-free survival rate was 66.3 % (95 %CI = [54.2; 75.9]). Most patients presented with acute haematological toxicities during CSI (85.9 %), predominantly severe thrombocytopenia (39.7 %). Among the 64 patients assessed for medium- and long-term outcomes, 52 survived and 47 were alive and disease-free at the latest follow-up visit on record. There were 3.8 % secondary tumours: two meningiomas and one diffuse intrinsic pontine glioma. Adult and paediatric patients respectively presented with secondary cataract (4.3 % vs 22.0 %), persistent hearing disorders (26.1 % vs 29.3 %), pulmonary or cardiac late effects (4.3 % vs 2.4 %), hormonal pituitary gland deficiencies (30.0 % vs 56.8 %) and psycho-cognitive disorders (56.5 % vs 53.7 %). Conclusion: CSI dispensed by HT, did not result in any additional acute or late toxicities when compared to 3D-CSI. There was no increase in the secondary tumour rate compared to that reported in the literature. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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