Local Control With Reduced-Dose Radiation Therapy for High-Risk Neuroblastoma: Results From a Prospective Clinical...

Area of Science:

• Pediatric Oncology
• Radiation Oncology
• Clinical Trials

Background:

• High-risk neuroblastoma (HR-NB) requires effective treatment strategies.
• Limited data exists on reduced-dose radiation therapy (RT) for HR-NB post-gross total resection (GTR).

Purpose of the Study:

• To evaluate local control, toxicity, and survival outcomes of reduced-dose RT in HR-NB patients with GTR.
• To assess the feasibility of 15 Gy or 18 Gy RT to the primary site.

Main Methods:

• Prospective pilot study including 78 HR-NB patients with GTR after induction therapy.
• Patients received 15 Gy or 18 Gy RT to the primary site in twice-daily fractions.
• Primary outcome was local failure (LF); secondary outcomes included survival and acute toxicity.

Main Results:

• A 96% local control rate was observed at 5 years post-RT (2.6% at 1 year, 3.9% at 5 years).
• No significant difference in local failure, overall survival (OS), event-free survival (EFS), or distant-metastasis-free survival (DMFS) between 15 Gy and 18 Gy cohorts.
• 41% of patients experienced grade 1-2 acute toxicity (fatigue, nausea, decreased appetite).

Conclusions:

• Reduced-dose RT (15-18 Gy) is effective for local control in HR-NB patients with GTR.
• This RT regimen is associated with a high rate of local control and low acute toxicity.
• Further investigation into long-term outcomes is warranted.