Role of early and aggressive post-operative radiation therapy in improving outcome for pediatric central nervous system atypical teratoid/rhabdoid tumor

Autor: Hsin Hung Chen, Hsiu Ju Yen, Wan Chin Yang, Yu Wen Hu, Tai-Tong Wong, Yi Wei Chen, Yi Yen Lee, Muh Lii Liang
Rok vydání: 2019
Předmět:
Male
Oncology
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Central nervous system
Central Nervous System Neoplasms
03 medical and health sciences
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Post operative
Child
Until Disease Progression
Rhabdoid Tumor
Retrospective Studies
business.industry
Disease progression
Hematopoietic Stem Cell Transplantation
Teratoma
Infant
General Medicine
medicine.disease
Combined Modality Therapy
Optimal management
Radiation therapy
medicine.anatomical_structure
Chemotherapy
Adjuvant
Child
Preschool
030220 oncology & carcinogenesis
Pediatrics
Perinatology and Child Health
Atypical teratoid rhabdoid tumor
Female
Radiotherapy
Adjuvant
Neurology (clinical)
Neurosurgery
business
Craniotomy
030217 neurology & neurosurgery
Zdroj: Child's Nervous System. 35:1013-1020
ISSN: 1433-0350
0256-7040
Popis: The purpose of the study is to evaluate possible prognostic factors and optimal management for pediatric atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system (CNS).Twenty-eight pediatric patients with CNS AT/RT who were treated with radiation therapy (RT) as part of multimodality treatment regimens at a single institution (1996-2015) were reviewed. Survival outcomes were analyzed in relation to possible prognostic factors.The 28 patients analyzed were followed up for a median 48-month period. Median progression-free survival (PFS) was 11 months, and overall survival (OS) was 57 months. Patients 3 years old had RT delayed for a longer period after surgery (p = 0.04), and the mean RT dose to tumor bed was lower (p 0.01) than in patients ≥ 3 years old. In multivariate analysis, a higher primary tumor bed RT dose was identified as a favorable prognostic factor for both PFS (hazard ratio [HR] = 0.85 per gray, p 0.01) and OS (HR = 0.92 per gray, p = 0.02). In addition, an interval between surgery and RT initiation 2 months, with disease progression observed before RT, as compared with an interval ≤ 2 months without disease progression prior to RT, was associated with worse PFS (HR = 8.50, p 0.01) and OS (HR = 5.27, p 0.01).Early and aggressive RT after surgery is critical for successful disease control in AT/RT patients. Conversely, a delay in RT until disease progression is observed that leads to unfavorable outcomes.
Databáze: OpenAIRE
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