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Re-irradiation for Paediatric Tumours.
1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|November 3, 2018
Summary
Re-irradiation, a second course of radiation therapy, offers salvage treatment for children with recurrent brain tumors like ependymoma and medulloblastoma, providing disease control and symptom relief.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Background:
- Cancer recurrence in children often occurs despite initial multimodal therapy, including radiation.
- Re-irradiation involves a second radiation course overlapping with the initial treatment volume.
- It serves as a crucial salvage option for various pediatric brain tumors.
Purpose of the Study:
- To review the role and outcomes of re-irradiation in pediatric cancer recurrence.
- To highlight its efficacy in specific tumor types and discuss safety considerations.
Main Methods:
- Literature review of re-irradiation studies in pediatric oncology.
- Analysis of outcomes including disease control, symptom palliation, and toxicity.
- Examination of specific pediatric brain tumor types: ependymoma, diffuse intrinsic pontine glioma, medulloblastoma, and germinoma.
Main Results:
- Conventionally fractionated re-irradiation shows long-term disease control with low toxicity in ependymoma.
- Re-irradiation offers symptom palliation and survival gain in diffuse intrinsic pontine glioma.
- Craniospinal re-irradiation may provide long-term control for medulloblastoma and intracranial germinoma.
Conclusions:
- Re-irradiation is an effective salvage strategy for recurrent pediatric brain tumors.
- Careful dose delivery to minimize organ-at-risk toxicity is essential.
- Re-irradiation should be considered alongside other salvage treatments like surgery or systemic therapy.
