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Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1319-23. doi: 10.1016/j.ijrobp.2008.03.033. Epub 2008 May 15.

Radiation is an important component of multimodality therapy for pediatric non-pineal supratentorial primitive neuroectodermal tumors.

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  • 1Department of Radiation Oncology, University of California-San Francisco, San Francisco, CA.

Abstract

PURPOSE:

To review a historical cohort of pediatric patients with supratentorial primitive neuroectodermal tumors (sPNET), to clarify the role of radiation in the treatment of these tumors.

PATIENTS AND METHODS:

Fifteen children aged <18 years with non-pineal sPNETs diagnosed between 1992 and 2006 were identified. Initial therapy consisted of surgical resection and chemotherapy in all patients and up-front radiotherapy (RT) in 5 patients. Five patients had RT at the time of progression, and 5 received no RT whatever. Kaplan-Meier estimates of overall survival were then calculated.

RESULTS:

The median follow-up from diagnosis for all patients was 31 months (range, 0.5-165 months) and for surviving patients was 49 months (range, 10-165). Of the 5 patients who received up-front RT, all were alive without evidence of disease at a median follow-up of 50 months (range, 25-165 months). Only 5 of the 10 patients who did not receive up-front RT were alive at last follow-up. There was a statistically significant difference in overall survival between the patient group that received up-front RT and the group that did not (p = 0.048). In addition, we found a trend toward a statistically significant improvement in overall survival for those patients who received gross total resections (p = 0.10).

CONCLUSIONS:

Up-front RT and gross total resection may confer a survival benefit in patients with sPNET. Local failure was the dominant pattern of recurrence. Efforts should be made to determine patients most likely to have local failure exclusively or as a first recurrence, in order to delay or eliminate craniospinal irradiation.

PMID:
18485615
[PubMed - indexed for MEDLINE]
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