| Abstrakt: |
Introduction: Pediatric cancer in Mexico continues to be a health problem with an average 5-year global survival rate of 60%. Solid tumors take third place behind leukemias/ lymphomas and brain tumors, with localized advance staging found at the time of diagnosis in 2/3 of cases. The incidence of metastasis to the lung in this group of patients is found in 25% of the cases. Traditionally, surgery is the treatment of choice. However, we find patients with several resections or whose localization calls for pneumonectomy, which impacts on quality of life. The use of radiotherapy in general is omitted as far as possible in the pediatric population which is the reason that SBRT case reports is scarce. Hypothesis: Pioneering institutional experience in SABR management of oligometastatic illness in pediatric populations in Mexico Material and methods: At the ABC Medical Center, between May 2019 and November 2021, we have treated 6 patients with diagnosis of stage IV oligometastatic sarcoma with a total of 8 treated lesions: lung (4), spine (4). All were treated with SABR, Novalis Tx equipment with 18-60Gy/1-8 (fr) fractions. Results: Follow-up has been 6.5 months The average age of our population was 12 years (range 6-14), two female and 4 males. The diagnoses were: Ewing Sarcoma (3), adrenal carcinoma (1), Triton Tumor (1), carcinoid tumor (1). The total doses used were 30Gy: SRS technique 18 Gy/1fr. or 27Gy/3fr. and SBRT technique 30-50Gy/5fr. and 60 Gy/8fr. fractioning. Tolerance of the treatment was good: no patient presented toxicity greater than 3-4 toxicity >grade 3-4. Treatment response: 1 complete response, 4 partial response, 2 stables, 1 progression. Mean survival time was 17.3 months. Conclusions: The use of SBRT is feasible and able to be reproduced in pediatric patients. It is well tolerated, allows for less invasive management and has a positive impact on the quality of life of patients with oligometastatic tumors. [ABSTRACT FROM AUTHOR] |
