Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation
| Autor: | Wendy B. London, Daphne A. Haas-Kogan, Stephanie W. Lee, Karen J. Marcus, Alexei L. Polishchuk, Suzanne Shusterman, Katherine K. Matthay, Hasan Al-Sayegh, Christine E. Hill-Kayser, Rochelle Bagatell, Steven G. DuBois, Lisa Diller, Richard Li, Randall A. Hawkins |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research Adrenal Gland Neoplasms Kaplan-Meier Estimate Disease Neuroblastoma 0302 clinical medicine Clinical Protocols High risk neuroblastoma Child Fisher's exact test Radiation Induction Chemotherapy Total body irradiation Combined Modality Therapy 3-Iodobenzylguanidine Child Preschool 030220 oncology & carcinogenesis symbols Female Whole-Body Irradiation Risk medicine.medical_specialty Adolescent Subsequent Relapse Bone Neoplasms Multimodality Therapy Transplantation Autologous Statistics Nonparametric 03 medical and health sciences symbols.namesake Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Avidity Retrospective Studies business.industry Infant medicine.disease Surgery 030104 developmental biology Neoplasm Recurrence Local Radiopharmaceuticals business Stem Cell Transplantation |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 97:270-277 |
| ISSN: | 0360-3016 |
| Popis: | Purpose External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease ( P =.03). Conclusions Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy. |
| Databáze: | OpenAIRE |
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