Document Detail

Preliminary results from a Phase II trail of conformal radiation therapy for pediatric patients with localised low-grade astrocytoma and ependymoma.
MedLine Citation:
PMID:  11872277     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To estimate the local control and patterns of failure for pediatric patients with low-grade astroglial tumors (LGA) and ependymoma (EP) treated with three-dimensional conformal radiation therapy (CRT) using an anatomically defined clinical target volume (CTV). METHODS AND MATERIALS: From an ongoing, prospective Phase II trial initiated in July 1997, 102 pediatric patients with LGA (n = 38) and EP (n = 64) have been treated with CRT using an anatomically defined CTV extending 1.0 cm beyond the gross tumor volume and a 0.5-cm margin (planning target volume) extending outside of the CTV. The prescribed dose was 54 Gy (LGA) and 59.4 Gy (EP). RESULTS: Patients with EP have been followed for a median of 17 months (range 3--43 months), and six failures have occurred. Patients with LGA have been followed for a median of 17 months (3--44 months), and four failures have occurred. Three-dimensional magnetic resonance (MR) studies performed to document treatment failure were registered with the MR and computed tomography (CT) data used in the treatment planning process. Failure occurred within the CTV for 5 patients with EP, including 3 with concurrent subarachnoid dissemination. One patient with EP developed metastatic disease with no evidence of local failure. Three patients with LGA failed within the CTV and one failed immediately outside of the CTV. CONCLUSIONS: Treatment of an anatomically defined CTV, encompassing 1.0 cm of non-involved brain beyond the margin of resection or neuroimaging-defined tumor, appears to be safe for pediatric patients with LGA and EP based on these preliminary data. Normal tissue sparing through the use of advanced radiation therapy treatment planning and delivery techniques should be beneficial to pediatric patients if the rate and patterns of failure are similar to conventional techniques and toxicity reduction can be objectively documented.
Thomas E Merchant; Yunping Zhu; Stephen J Thompson; Marc R Sontag; Richard L Heideman; Larry E Kun
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  52     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-03-01     Completed Date:  2002-03-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  325-32     Citation Subset:  IM    
Department of Radiation Oncology St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
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MeSH Terms
Astrocytoma / pathology,  radiotherapy*
Brain Neoplasms / pathology,  radiotherapy*
Child, Preschool
Ependymoma / pathology,  radiotherapy*
Follow-Up Studies
Prospective Studies
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal / methods*
Grant Support

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

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