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 |
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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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