Intraoperative radiation therapy for high-risk pediatric neuroblastoma.


Journal Article

PURPOSE:To evaluate the efficacy of intraoperative radiation therapy (IORT) in the treatment of high-risk pediatric neuroblastoma. METHODS AND MATERIALS:Between 1986 and 1998, 23 children received IORT for pediatric neuroblastoma. Electron beam energies ranged from 4 MeV to 16 MeV and median dose was 10 Gy (7-16 Gy). RESULTS:Twenty-one of 23 patients were classified as high-risk. A gross total resection (GTR) was achieved in 18 patients, of whom 6 experienced disease recurrence, 2 of which included a locoregional relapse as a component of failure. Fourteen of 18 patients receiving IORT after a GTR are disease-free survivors. A second subset of 5 patients had a subtotal resection (STR), with gross residual disease remaining after surgery. All 5 patients recurred locally, and all died of their disease. IORT was extremely well-tolerated in our cohort. Surgical resection and IORT resulted in the narrowing of the abdominal aorta and an atrophic kidney in 1 patient. CONCLUSIONS:For high-risk neuroblastoma patients, IORT as the only radiotherapy to the primary, produced excellent local control after a GTR. However, IORT as the sole radiotherapy to the primary was inadequate for patients with extensive adenopathy or an STR. In this setting, we are exploring the use of IORT as a boost in conjunction with external beam radiation therapy.

Full Text

Cited Authors

  • Haas-Kogan, DA; Fisch, BM; Wara, WM; Swift, PS; Farmer, DL; Harrison, MR; Albanese, C; Weinberg, V; Matthay, KK

Published Date

  • July 2000

Published In

Volume / Issue

  • 47 / 4

Start / End Page

  • 985 - 992

PubMed ID

  • 10863069

Pubmed Central ID

  • 10863069

Electronic International Standard Serial Number (EISSN)

  • 1879-355X

International Standard Serial Number (ISSN)

  • 0360-3016

Digital Object Identifier (DOI)

  • 10.1016/s0360-3016(00)00432-6


  • eng