Online quality control, hyperfractionated radiotherapy alone and reduced boost volume for standard risk medulloblastoma: long-term results of MSFOP 98
| Autor: | Martine Mege, Marie Helene Baron, Jean Philippe Maire, Dominique Figarella-Branger, M Benhassel, Philippe Maingon, Claire Alapetite, Sophie Chapet, Christian Carrie, Marc Mahé, Sophie Dussart, Philippe Quetin, Valérie Bernier, Line Claude, Jean Louis Habrand, Pierre Clavere, Anne Laprie, Jacques Grill, Laetitia Padovani |
|---|---|
| Přispěvatelé: | Pharmacologie et nouveaux traitements des cancers, Université Paris-Sud - Paris 11 ( UP11 ) -Institut Gustave Roussy ( IGR ), Service de pathologie et neuropathologie, CHU Marseille, Centre Alexis Vautrin ( CAV ), Centre Alpin de Recherche sur les Réseaux Trophiques et Ecosystèmes Limniques ( CARRTEL ), Institut National de la Recherche Agronomique ( INRA ) -Université Savoie Mont Blanc ( USMB [Université de Savoie] [Université de Chambéry] ), Service de radiothérapie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Pôle Kaplan de cancérologie, Hôpital Bretonneau-CHRU Tours, Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR), Centre Alexis Vautrin (CAV), Centre Alpin de Recherche sur les Réseaux Trophiques et Ecosystèmes Limniques (CARRTEL), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC) |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Cancer Research
MESH: Combined Modality Therapy [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging medicine.medical_treatment MESH: Quality Control MESH : Child Preschool Craniospinal Irradiation [ SDV.CAN ] Life Sciences [q-bio]/Cancer 0302 clinical medicine [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing MESH : Child MESH: Child MESH: Dose Fractionation Longitudinal Studies Child MESH: Longitudinal Studies MESH: Radiotherapy Dosage Dose Fractionation Adjuvant MESH : Longitudinal Studies Brain Neoplasms MESH : Radiotherapy Dosage Wechsler Adult Intelligence Scale Radiotherapy Dosage MESH : Quality Control MESH: Follow-Up Studies Combined Modality Therapy 3. Good health [PHYS.MECA.ACOU]Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph] MESH: Internet Oncology 030220 oncology & carcinogenesis [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] Child Preschool MESH: Survival Analysis MESH: Brain Neoplasms [PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph] [SDV.IB]Life Sciences [q-bio]/Bioengineering [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] MESH : Internet Craniospinal [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing Quality Control Adolescent MESH: Radiotherapy Adjuvant [SDV.CAN]Life Sciences [q-bio]/Cancer MESH : Medulloblastoma MESH : Radiotherapy Adjuvant 03 medical and health sciences MESH : Cognition Disorders MESH : Adolescent medicine [INFO.INFO-IM]Computer Science [cs]/Medical Imaging Humans Preschool MESH : Brain Neoplasms Survival analysis MESH: Medulloblastoma Medulloblastoma [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph] MESH: Adolescent Internet MESH: Humans Radiotherapy business.industry MESH : Dose Fractionation MESH: Child Preschool MESH : Humans Dose fractionation MESH : Follow-Up Studies medicine.disease Survival Analysis Radiation therapy MESH: Cognition Disorders Radiotherapy Adjuvant Dose Fractionation Radiation MESH : Survival Analysis Nuclear medicine business Cognition Disorders MESH : Combined Modality Therapy 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Clinical Oncology Journal of Clinical Oncology, American Society of Clinical Oncology, 2009, 27 (11), pp.1879-1883. 〈10.1200/JCO.2008.18.6437〉 Journal of Clinical Oncology, American Society of Clinical Oncology, 2009, 27 (11), pp.1879-1883. ⟨10.1200/JCO.2008.18.6437⟩ Journal of Clinical Oncology, American Society of Clinical Oncology, 2009, ⟨10.1200/JCO.2008.18.6437⟩ 1. Annual Meeting of the Paediatric-Radiation-Oncology-Society |
| ISSN: | 0732-183X 1527-7755 |
| DOI: | 10.1200/JCO.2008.18.6437〉 |
| Popis: | Purpose To determine event free and overall survival, and long-term cognitive sequelae of children with standard-risk medulloblastoma (SRM) treated with hyperfractionated radiotherapy, conformal reduced boost volume without chemotherapy, and online quality assurance. Patients and Methods Forty-eight patients (age 5 to 18 years) were included in the Medulloblastoma-Société Française d'Oncologie Pédiatrique (MSFOP 98) protocol (December 1998 to October 2001). Patients received hyperfractionated radiotherapy (HFRT; 36 Gy, 1 Gy/fraction twice per day) to the craniospinal axis followed by a boost to the tumor bed (1.5-cm margin) to a dose of 68 Gy. Records of craniospinal irradiation were reviewed before treatment started. Neuropsychologic evaluations were done according to the protocol (1, 3, 5, and 7 years after irradiation). Cognitive outcomes were followed longitudinally with full-scale intelligence quotient (FSIQ) obtained with age-adapted Wechsler scales. Results After a median follow-up of 77.7 months, 6-year overall survival (OS) and event-free survival (EFS) rates for the cohort were 78% (95% CI, 66% to 90%) and 75%, respectively (95% CI, 62% to 87%). Thanks to quality control, 14 major deviations were detected. Annual full scale IQ decline was 2 points over a 6-year period. Predicted change in FSIQ points per year was 2.15 (95% CI, −1.24 to 3.51) with an intercept (ie, predicted FSIQ) of 93.57 at baseline. Conclusion HFRT protocol with conformal reduced boost and online quality control allows excellent long-term OS and EFS in the absence of chemotherapy. In addition, FSIQ drops seem to be less pronounced than previously reported with standard irradiation regimens. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|