Intraoperative radiation therapy for high-risk pediatric neuroblastoma.
To evaluate the efficacy of intraoperative radiation therapy (IORT) in the treatment of high-risk pediatric neuroblastoma.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).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.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.
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Related Subject Headings
- Urinary Bladder Neoplasms
- Survival Analysis
- Retroperitoneal Neoplasms
- Remission Induction
- Radiotherapy, Adjuvant
- Prognosis
- Oncology & Carcinogenesis
- Neuroblastoma
- Neoplasm Staging
- Neoplasm Recurrence, Local
Citation
Published In
DOI
EISSN
ISSN
Publication Date
Volume
Issue
Start / End Page
Related Subject Headings
- Urinary Bladder Neoplasms
- Survival Analysis
- Retroperitoneal Neoplasms
- Remission Induction
- Radiotherapy, Adjuvant
- Prognosis
- Oncology & Carcinogenesis
- Neuroblastoma
- Neoplasm Staging
- Neoplasm Recurrence, Local