Document Detail


Impact of radiotherapy parameters on outcome for patients with supratentorial primitive neuro-ectodermal tumours entered into the SIOP/UKCCSG PNET 3 study.
MedLine Citation:
PMID:  19328574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: To evaluate the impact of radiotherapy (RT) parameters on outcome in the SIOP/UKCCSG study of pre-RT chemotherapy for Supratentorial Primitive Neuro-ectodermal Tumours. METHODS AND MATERIALS: Sixty-two patients aged 2.9-16.6 (median 6.4 years) were eligible. Forty-eight (77%) had non-pineal sites and 14 (23%) had pineal sites. Eleven were randomized to RT alone (6) and five to pre-RT Vincristine, Etoposide, Carboplatin and Cyclophosphamide. Fifty-one were not randomized, 15 receiving RT alone and 36 receiving pre-RT chemotherapy. Craniospinal RT (CSRT) 35 Gy/21 fractions were followed by 20 Gy/12 fractions to primary tumour. RESULTS: Mean CSRT dose was 34.7 Gy and mean total primary dose was 53.4 Gy for those who received radiotherapy. Of 30 relapses, 18 (60%) were local only and 5 (16.7%) were combined local and leptomeningeal. There was no significant impact on Overall Survival (OS) or Event-Free Survival (EFS) of surgery-RT interval for patients treated by pre-RT chemotherapy or RT alone, or duration of RT (completing within 50 days). Planning films were received for 42/54 (77.8%) patients. Fourteen (33%) had one or more targeting deviations (10 cribriform fossa, 11 base of skull). There was a statistically significant increase in the risk of recurrence for patients with cribriform fossa targeting deviations (p=0.033), but not for patients with base of skull targeting deviations (p=0.242). There was no statistically significant difference in OS (p=0.0598) or EFS (p=0.0880) for patients who had one or more targeting deviations compared to those who had none. CONCLUSIONS: This study has not demonstrated a statistically significant impact of radiotherapy duration or targeting deviations on OS or EFS, possibly due to small patient numbers. However, multi-institutional SPNET trials should incorporate quality assurance programs including analysis of relapse pattern in relation to primary target volume coverage.
Authors:
Roger E Taylor; Paul H J Donachie; Claire L Weston; Kathryn J Robinson; Helen Lucraft; Frank Saran; David W Ellison; James Ironside; David A Walker; Barry L Pizer;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-26
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  92     ISSN:  1879-0887     ISO Abbreviation:  Radiother Oncol     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-10-27     Revised Date:  2009-12-16    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  83-8     Citation Subset:  IM    
Affiliation:
Swansea University, Swansea, UK. Roger.Taylor@Swansea-tr.wales.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child, Preschool
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Male
Neoplasm Recurrence, Local / drug therapy,  radiotherapy*
Neuroectodermal Tumors, Primitive / drug therapy,  radiotherapy*
Radiation Dosage
Randomized Controlled Trials as Topic
Supratentorial Neoplasms / drug therapy,  radiotherapy*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Cancer Research UK

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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