Clinical outcomes and efficacy of stereotactic body radiation therapy in children, adolescents, and young adults with metastatic solid tumors.

Abstract

OBJECTIVE:

The objective of this study is to report disease outcomes and toxicity with the use of stereotactic body radiation therapy (SBRT) in the treatment of pediatric metastatic disease.

METHODS:

All pediatric and adolescent young adult (AYA) patients' who received SBRT were included between the years 2000 and 2020. Study endpoints included local control (LC), progression-free survival (PFS), overall survival (OS), cumulative incidence (CI) of death or local failure and toxicity. The end points with respect to survival and LC were calculated using the Kaplan-Meier estimate. The cumulative incidence of local failure was calculated using death as a competing risk.

RESULTS:

16 patients with 36 lesions irradiated met inclusion criteria and formed the study cohort. The median OS and PFS for the entire cohort were 17 months and 15.7 months, respectively. The 1 year OS for the entire cohort was 75%. The 6- and 12 month local control was 85 and 78%, respectively. There were no local failures in irradiated lesions for patients who received a BED10≥100 Gy. Patients who were treated with SBRT who had ≤5 metastatic lesions at first recurrence had a superior 1 year OS of 100 vs 50% for those with >5 lesions. One patient (6.3%) experienced a Grade 3 central nervous system toxicity.

CONCLUSION:

LC was excellent with SBRT delivered to metastatic disease, particularly for lesions receiving a BED10≥100 Gy. High-grade toxicity was rare in our patient population. Patients with five or fewer metastatic sites have a significantly better OS compared to >5 sites.

ADVANCES IN KNOWLEDGE:

This study demonstrates that SBRT is safe and efficacious in the treatment of pediatric oligometastatic disease.

• Authors: Sujith Baliga, Jennifer Matsui, Brett Klamer, Ashley Cetnar, Ashlee Ewing, Catherine Cadieux, Ajay Gupta, Bhuvana A Setty, Ryan D Roberts, Randal S Olshefski, Timothy P Cripe, Thomas J Scharschmidt, Jennifer Aldrink, Elaine Mardis, Nicholas D Yeager, Joshua David Palmer
• Journal: The British journal of radiology (Br J Radiol) Vol. 95 Issue 1133 Pg. 20211088 (May 01 2022) ISSN: 1748-880X [Electronic] England
• PMID: 35073182 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Humans
• Kaplan-Meier Estimate
• Neoplasms (radiotherapy)
• Neoplasms, Second Primary (etiology)
• Progression-Free Survival
• Radiosurgery (adverse effects, methods)
• Retrospective Studies
• Treatment Outcome
• Young Adult