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Current Oncology
Par Palak P Patel, Hesham M. Elhalawani, Karen Jean Marcus et 10 autres.
Contenu en anglais
Limited data exist regarding the safety and efficacy of photon re-irradiation with whole-brain radiotherapy (WBRT) or craniospinal irradiation (CSI) in children with recurrent or second primary CNS tumors.
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In this retrospective single-institution study, 23 patients < 21 years who underwent photon re-irradiation with WBRT (n = 9) or CSI (n = 14) for CNS tumors between 2013 and 2026 were included. Clinical and treatment characteristics were collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Toxicities were graded using CTCAE v5.0.
In our cohort, the median age at diagnosis was 8.5 years (range: 0.2–19.7 years), and medulloblastoma was the most common histology (30%). Median time to the first relapse after initial irradiation was 12.0 months (range: 0.9–92.5 months). Median re-irradiation dose to the whole brain or craniospinal axis was 24.0 Gy (range: 20.0–36.0 Gy). For 15 patients who received involved field boosts, median total dose was 30.6 Gy (range: 20.0–54.0 Gy). With median follow-up after re-RT of 12.2 months (range: 1.0–106.8), 12-month PFS and OS were 24.2% and 67.0%, respectively. Four patients who received curative-intent re-CSI remain alive with median follow-up of 20.4 months (range: 5.8–106.8). The crude rate of grade >2 CNS toxicity was 8.7%. Of 10 patients with new neurologic symptoms before re-irradiation, 7 (70%) had symptomatic improvement after treatment.
Photon re-irradiation with WBRT or CSI was feasible and achieved disease control in a subset of patients and meaningful symptom palliation with acceptable acute toxicity. Careful attention to cumulative dose constraints is essential, and longer follow-up is needed to assess durability and late effects.
Publié dans Current Oncology. Le résumé est reproduit tel qu’il a été publié et reste l’œuvre de ses auteurs ; lisez l’article complet à la source.
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