Endocrine complications in children treated for medulloblastoma or ependymoma using radiation therapy. Outcomes in the CT-planning era
| العنوان: | Endocrine complications in children treated for medulloblastoma or ependymoma using radiation therapy. Outcomes in the CT-planning era |
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| المؤلفون: | N.J. Laperriere, David C. Hodgson, G. Bahl, Stacey Urbach, A. Parent, Ute Bartels, Susan Awrey, Lisa W. Le, B.A. Millar |
| المصدر: | Journal of Clinical Oncology. 27:10064-10064 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Ependymoma, Medulloblastoma, Cancer Research, medicine.medical_specialty, Ct planning, business.industry, medicine.medical_treatment, medicine.disease, Surgery, Radiation therapy, Oncology, medicine, Endocrine system, Radiology, business |
| الوصف: | 10064 Background: The purpose of this study is to determine the frequency of late endocrine complications following radiation therapy (RT) in children treated for medulloblastomas or ependymomas. Methods: Seventy children with medulloblastoma or ependymoma were treated using RT from June 2000 to June 2005 at our institute. Median age at diagnosis was 6 years (range 1–17), and 52 (74%) were boys. Forty-eight patients (69%) had medulloblastomas and 22 (31%) had ependymomas. Twenty-two received highly conformal RT to the tumor bed alone (focal RT: median dose 54 Gy, range 54–59.4), 24 received low dose cranio-spinal RT (CSI: median dose 23.4 Gy) followed by a boost to the post fossa/tumor bed (median 30.6 Gy), and 24 patients received high dose CSI (median 36 Gy) followed by a boost (median 18 Gy). Only two of the 22 children with ependymomas received CSI. All patients underwent CT-based planning and were treated using conventional fractionation; 58 (83%) also received chemotherapy. None of the children had documented endocrinopathy prior to diagnosis. Results: After a median follow-up of 65.3 months, the 5-yr PFS and OS was 70% and 75% for children with medulloblastomas, and 54% and 84% for patients with ependymomas, respectively. Thirty-five children developed evidence of endocrinopathy (Growth hormone deficiency (GHD): 31, hypothyroidism (HPT): 23, precocious puberty (PP): 6, gonadotropin deficiency: 3, ACTH deficiency: 2, and diabetes insipidus: 2). The 5-yr cumulative incidence (CI) of endocrinopathy was 71% for the children treated with CSI vs. 18% for those treated with focal RT (Gray's test p-value = 0.004). The median time to development of endocrinopathy was 38 months for the patients who had CSI. For these children the 5-yr CI was 68% for GHD, 52% for HPT, and 16% for PP. There was no significant difference in the incidence of endocrinopathy for patients treated with low dose vs. high dose CSI. Conclusions: The 5-yr CI of endocrine toxicity in children treated with cranio-spinal RT is 71% (median time to development: 38 months), which is significantly higher than in children treated with focal RT. All children treated for medulloblastomas or ependymomas require long-term surveillance and close monitoring for the development of endocrinopathies. No significant financial relationships to disclose. |
| تدمد: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2009.27.15_suppl.10064 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::e7ab633edb804d1dd6986550f0258dce https://doi.org/10.1200/jco.2009.27.15_suppl.10064 |
| رقم الانضمام: | edsair.doi...........e7ab633edb804d1dd6986550f0258dce |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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| DOI: | 10.1200/jco.2009.27.15_suppl.10064 |