Reirradiation of Pediatric Tumors Using Hypofractionated Stereotactic Radiotherapy

Technol Cancer Res Treat. 2017 Apr;16(2):195-202. doi: 10.1177/1533034616655952. Epub 2016 Jul 8.

Abstract

Background: This study aimed to evaluate the efficacy and safety of hypofractionated stereotactic radiotherapy for reirradiation of recurrent pediatric tumors.

Methods and materials: The study included 23 pediatric patients who were reirradiated using hypofractionated stereotactic radiotherapy in the radiation oncology department between January 2008 and November 2013. In total, 33 tumors were treated-27 (82%) cranial and 6 (18%) extracranial. Hypofractionated stereotactic radiotherapy was administered due to recurrent disease in 31 (94%) tumors and residual disease in 2 (6%) tumors. The median total dose was 25 Gy (range: 15-40 Gy), and the median follow-up was 20 months (range: 2-68 months).

Results: The 1-year and 2-year local control rates in the entire study population were 42% and 31%, respectively. The median local control time was 11 months (range: 0-54 months) following hypofractionated stereotactic radiotherapy. The patients with tumor response after hypofractionated stereotactic radiotherapy had significantly longer local control than the patients with post-hypofractionated stereotactic radiotherapy tumor progression (21 vs 3 months, P < .001). Tumor volume <1.58 cm3 was correlated (not significantly) with better local control (23 vs 7 months, P = .064).

Conclusion: Reirradiation of pediatric tumors using hypofractionated stereotactic radiotherapy is a safe and effective therapeutic approach. This treatment modality should be considered as a treatment option in selected pediatric patients.

Keywords: hypofractionation; pediatric tumors; reirradiation; stereotactic body radiotherapy; stereotactic radiotherapy.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Dose Fractionation, Radiation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Neoplasms / diagnosis*
  • Neoplasms / mortality
  • Neoplasms / radiotherapy*
  • Prognosis
  • Radiosurgery* / adverse effects
  • Radiosurgery* / methods
  • Radiotherapy Dosage
  • Re-Irradiation*
  • Treatment Outcome
  • Tumor Burden