Intraoperative radiation therapy for high-risk pediatric neuroblastoma

Daphne A. Haas-Kogan, Benjamin M. Fisch, William M. Wara, Patrick S. Swift, Diana L Farmer, Michael R. Harrison, Craig Albanese, Vivian Weinberg, Katherine K. Matthay

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Purpose: To evaluate the efficacy of intraoperative radiation therapy (IORT) in the treatment of high-risk pediatric neuroblastoma.Methods and Materials: Between 1986 and 1998, 23 children received IORT for pediatric neuroblastoma. Electron beam energies ranged from 4 MeV to 16 MeV and median dose was 10 Gy (7-16 Gy).Results: Twenty-one of 23 patients were classified as high-risk. A gross total resection (GTR) was achieved in 18 patients, of whom 6 experienced disease recurrence, 2 of which included a locoregional relapse as a component of failure. Fourteen of 18 patients receiving IORT after a GTR are disease-free survivors. A second subset of 5 patients had a subtotal resection (STR), with gross residual disease remaining after surgery. All 5 patients recurred locally, and all died of their disease. IORT was extremely well-tolerated in our cohort. Surgical resection and IORT resulted in the narrowing of the abdominal aorta and an atrophic kidney in 1 patient.Conclusions: For high-risk neuroblastoma patients, IORT as the only radiotherapy to the primary, produced excellent local control after a GTR. However, IORT as the sole radiotherapy to the primary was inadequate for patients with extensive adenopathy or an STR. In this setting, we are exploring the use of IORT as a boost in conjunction with external beam radiation therapy. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)985-992
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume47
Issue number4
DOIs
StatePublished - Jul 1 2000

Keywords

  • Intraoperative radiation
  • Neuroblastoma
  • Pediatric

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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    Haas-Kogan, D. A., Fisch, B. M., Wara, W. M., Swift, P. S., Farmer, D. L., Harrison, M. R., Albanese, C., Weinberg, V., & Matthay, K. K. (2000). Intraoperative radiation therapy for high-risk pediatric neuroblastoma. International Journal of Radiation Oncology Biology Physics, 47(4), 985-992. https://doi.org/10.1016/S0360-3016(00)00432-6