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Palliative radiotherapy in paediatric malignancies
S Bhasker1, V Bajpai, A Turaka
1Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi 110029, India. bhaskersuman@rediffmail.com
Insights
Palliative radiotherapy in children with incurable cancers effectively manages symptoms, especially when combined with other treatments. This approach offers significant relief for paediatric malignancies.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Palliative Care
Background:
- Palliative treatment for childhood malignancies presents significant challenges.
- This study investigates the efficacy of palliative radiotherapy in managing incurable pediatric cancers.
Purpose of the Study:
- To evaluate the role and effectiveness of palliative radiotherapy in symptom control for children with incurable malignancies.
- To assess the impact of palliative radiotherapy as part of multimodal treatment.
Main Methods:
- Retrospective analysis of 40 pediatric patients treated between January 2003 and November 2005.
- Patients received palliative external beam radiotherapy for symptom control, often combined with surgery, chemotherapy, or medications.
- Radiotherapy doses ranged from single fractions (5-8 Gy) to fractionated schedules (20-30 Gy).
Main Results:
- Common symptoms included swelling, pain, bleeding, and limb weakness.
- Malignant round cell tumors were most frequent; 45% of patients had disseminated disease at presentation.
- Symptomatic relief was achieved in 88% of patients (complete or good relief), with tumor response observed in 55% (complete or partial response).
Conclusions:
- Palliative radiotherapy is a valuable modality for symptom management in pediatric oncology.
- Combining radiotherapy with other treatment modalities enhances symptomatic relief in children with locally advanced or incurable malignancies.
Introduction:
Providing effective palliative treatment in childhood malignancies is a challenging task. This study evaluated the role of palliative radiotherapy in the management of incurable paediatric malignancies.
Methods:
Records of 40 paediatric patients treated between January 2003 and November 2005 were reviewed and analysed retrospectively. All had received palliative external beam radiotherapy for symptom control either as a single modality or in addition to surgery, chemotherapy and drugs for symptomatic relief.
Results:
Predominant symptoms noticed were swelling with or without pain, bleeding, and weakness of limbs. Median duration of symptoms was 90 days. Malignant round cell tumours were most common followed by retinoblastoma, neuroblastoma, Ewing's sarcoma and acute myeloid leukaemia with chloromas. 45 percent of children had disseminated disease at presentation. Nine underwent surgery, while 32 patients received chemotherapy, and all but two received drugs for symptomatic relief in addition to palliative radiotherapy. Dose schedules were either 5 Gy or 8 Gy in single fraction, while for fractionated radiotherapy, the range was 20 Gy in five fractions to 30 Gy in ten fractions. With regard to symptomatic relief, four patients had complete relief, 20 showed good relief, 15 had little and one did not have any relief. On completion of multimodality treatment, tumour response was complete in two patients, 18 had partial response, eight had stable disease, eight had progressive disease, and the disease status of four was unknown.
Conclusion:
The role of radiotherapy as a palliative modality in children with locally-advanced lesions provides better symptomatic relief in combination with other treatment modalities.
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