Long-term side effects of radiotherapy for pediatric localized neuroblastoma : results from clinical trials NB90 and NB94.
Fiche publication
Date publication
juillet 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Dr BERNIER-CHASTAGNER Valérie, Dr MUNZER Martine
Tous les auteurs :
Ducassou A, Gambart M, Munzer C, Padovani L, Carrie C, Haas-Kogan D, Bernier-Chastagner V, Demoor C, Claude L, Helfre S, Bolle S, Leseur J, Huchet A, Rubie H, Valteau-Couanet D, Schleiermacher G, Coze C, Defachelles AS, Marabelle A, Ducassou S, Devalck C, Gandemer V, Munzer M, Laprie A
Lien Pubmed
Résumé
INTRODUCTION: Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94. PATIENTS AND METHODS: From 1990-2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at 2 years, +/- a 5 Gy boost in both age groups. RESULTS: The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5-21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy. CONCLUSION: After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy.
Référence
Strahlenther Onkol. 2015 Jul;191(7):604-12