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Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity.

Publication ,  Journal Article
Wang, E; Gutkin, PM; Oh, J; Pollom, E; Soltys, SG; Grant, GA; Prolo, LM; Chang, S; Li, G; Fisher, PG; Partap, S; Campen, CJ; Gibbs, IC; Hiniker, SM
Published in: Neurosurg Focus
November 2022

OBJECTIVE: Recurrence of brain tumors in children after the initial course of treatment remains a problem. This study evaluated the efficacy and safety of reirradiation using stereotactic radiosurgery (SRS) in patients with recurrent pediatric primary brain tumors. METHODS: This IRB-approved retrospective review included pediatric patients with recurrent primary brain tumors treated at Stanford University from 2000 to 2019 using frameless SRS. Time to local failure (LF) and distant intracranial failure (DIF) were measured from the date of SRS and analyzed using competing risk analysis. Overall survival (OS) and progression-free survival (PFS) were analyzed with the Kaplan-Meier method. RESULTS: In total, 37 patients aged 2-24 years (median age 11 years at recurrence) were treated for 48 intracranial tumors. Ependymoma (38%) and medulloblastoma (22%) were the most common tumor types. The median (range) single fraction equivalent dose of SRS was 16.4 (12-24) Gy. The median (range) follow-up time was 22.9 (1.5-190) months. The median OS of all patients was 36.8 months. Eight of 40 (20%) lesions with follow-up imaging locally recurred. The 2-year cumulative incidence of LF after reirradiation with SRS was 12.8% (95% CI 4.6%-25.4%). The 2-year cumulative incidence of DIF was 25.3% (95% CI 12.9%-39.8%). The median PFS was 18 months (95% CI 8.9-44). Five (10.4%) patients developed toxicities potentially attributed to SRS, including cognitive effects and necrosis. CONCLUSIONS: Reirradiation using SRS for recurrent pediatric brain tumors appears safe with good local control. Innovations that improve overall disease control should continue because survival outcomes after relapse remain poor.

Duke Scholars

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Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

November 2022

Volume

53

Issue

5

Start / End Page

E2

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiosurgery
  • Neurology & Neurosurgery
  • Neoplasm Recurrence, Local
  • Humans
  • Follow-Up Studies
  • Child
  • Cerebellar Neoplasms
  • Brain Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wang, E., Gutkin, P. M., Oh, J., Pollom, E., Soltys, S. G., Grant, G. A., … Hiniker, S. M. (2022). Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity. Neurosurg Focus, 53(5), E2. https://doi.org/10.3171/2022.8.FOCUS22361
Wang, Elyn, Paulina M. Gutkin, Justin Oh, Erqi Pollom, Scott G. Soltys, Gerald A. Grant, Laura M. Prolo, et al. “Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity.Neurosurg Focus 53, no. 5 (November 2022): E2. https://doi.org/10.3171/2022.8.FOCUS22361.
Wang E, Gutkin PM, Oh J, Pollom E, Soltys SG, Grant GA, et al. Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity. Neurosurg Focus. 2022 Nov;53(5):E2.
Wang, Elyn, et al. “Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity.Neurosurg Focus, vol. 53, no. 5, Nov. 2022, p. E2. Pubmed, doi:10.3171/2022.8.FOCUS22361.
Wang E, Gutkin PM, Oh J, Pollom E, Soltys SG, Grant GA, Prolo LM, Chang S, Li G, Fisher PG, Partap S, Campen CJ, Gibbs IC, Hiniker SM. Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity. Neurosurg Focus. 2022 Nov;53(5):E2.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

November 2022

Volume

53

Issue

5

Start / End Page

E2

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiosurgery
  • Neurology & Neurosurgery
  • Neoplasm Recurrence, Local
  • Humans
  • Follow-Up Studies
  • Child
  • Cerebellar Neoplasms
  • Brain Neoplasms