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Long-term side effects of radiotherapy for pediatric localized neuroblastoma

Abstract : 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, 34 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.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01195738
Contributor : Laurent Jonchère <>
Submitted on : Tuesday, September 8, 2015 - 1:09:44 PM
Last modification on : Sunday, October 25, 2020 - 7:08:05 AM

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Anne Ducassou, Marion Gambart, Caroline Munzer, Laetitia Padovani, Christian Carrie, et al.. Long-term side effects of radiotherapy for pediatric localized neuroblastoma. Strahlentherapie und Onkologie, Springer Verlag (Germany), 2015, 191 (7), pp.604--612. ⟨10.1007/s00066-015-0837-z⟩. ⟨hal-01195738⟩

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