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[Central nervous system irradiation for children with leukemia]
Gan No Rinsho. Japan Journal of Cancer Clinics
|February 1, 1984
Summary
Prophylactic cranial irradiation and intrathecal methotrexate improved survival for acute lymphoblastic leukemia patients. Careful attention to radiation field borders is crucial for optimal central nervous system (CNS) relapse-free survival.
Area of Science:
- Oncology
- Pediatric Hematology/Oncology
- Radiation Oncology
Context:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Central nervous system (CNS) relapse is a significant concern in ALL treatment.
- Prophylactic CNS irradiation was a standard treatment modality during the study period.
Purpose:
- To evaluate the long-term outcomes of prophylactic CNS irradiation in acute lymphoblastic leukemia (ALL) patients.
- To assess the effectiveness of cranial irradiation plus intrathecal methotrexate in preventing CNS relapse.
- To identify potential areas for improvement in CNS prophylactic irradiation techniques.
Summary:
- A cohort of 247 acute lymphoblastic leukemia patients received prophylactic cranial irradiation (2400 rad) plus intrathecal methotrexate between 1972 and 1981.
- At 5 years post-treatment, overall survival was 51%, relapse-free survival was 47%, and CNS relapse-free survival was 79%.
- Analysis revealed inconsistencies in radiation field coverage, with anterior/middle cranial fossae and the second cervical spine often excluded, potentially impacting efficacy.
Impact:
- Findings highlight the importance of precise radiation field planning in pediatric oncology.
- Suggests that optimizing radiation techniques could further improve CNS relapse-free survival in ALL.
- Informs current and future strategies for CNS-directed therapy in acute lymphoblastic leukemia.