Clinical outcomes and toxicity following palliative radiotherapy for childhood cancers. Issue 1 (29th August 2017)

• Record Type: Journal Article
• Authors: Mak, Kimberley S.; Lee, Stephanie W.; Balboni, Tracy A.; Marcus, Karen J.
• Is Part Of: Pediatric blood & cancer. Volume 65:Issue 1(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-08-29
• Subjects: radiation oncology -- radiotherapy -- palliative care -- toxicity; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.26764
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract: Background: Few reports of palliative radiotherapy (RT) for pedialltric malignancies have been published. We described clinical indications, outcomes, and toxicities for children who received palliative RT. Procedure: Pediatric patients (age ≤18 years) treated with palliative RT for incurable cancer from January 1 2008 to February 26, 2014 were included. Diagnosis, details of RT, treatment response, toxicity, and survival were retrospectively reviewed. Results: Forty‐six patients received 76 RT courses. Fifteen patients (33%) had ≥2 courses. Median age at palliative RT was 10.3 years; 54% were male. The most common diagnoses were neuroblastoma (20%) and diffuse intrinsic pontine glioma (17%). The most common indications for RT were oligometastatic disease in asymptomatic patients (39%) and pain (25%). The most common treatment sites were brain (32%) and bone (29%). Median RT dose was 30 Gy. Median number of RT fractions was 12. Sixty‐five treatment courses (86%) were delivered with fraction sizes ≥2.5 Gy. Twenty‐seven treatment courses (36%) were given under general anesthesia. Median follow‐up was 3.9 months. Grade 1–2 RT‐related toxicity occurred in 21% of treatment courses and 4–8% up to 12 months after RT. Two patients had Grade 3 toxicity during RT (esophagitis). Of symptomatic patients, 91%, 73%, 58%, and 43% had improved or stable symptoms during RT and 0–3, 3–6, and 6–12 months afterwards, respectively. Median survival after palliative RT was 4.2 months. Four of 21 surviving patients (19%) had hospice care at last follow‐up. Conclusions: Palliative RT was well tolerated in children with incurable malignancies, with most cases associated with acceptable toxicity, and improved or stable symptoms.