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Clinical Trial
. 2021 Aug;197(8):683-689.
doi: 10.1007/s00066-020-01718-5. Epub 2020 Dec 9.

Long-term follow-up of children with neuroblastoma receiving radiotherapy to metastatic lesions within the German Neuroblastoma Trials NB97 and NB 2004

Danny Jazmati  1 , Sarina Butzer  2 , Barbara Hero  2 , Jerome Doyen  3 , Dalia Ahmad Khalil  3 , Theresa Steinmeier  3 , Stefanie Schulze Schleithoff  3 , Angelika Eggert  4 , Thorsten Simon  2 , Beate Timmermann  5
Affiliations
Clinical Trial

Long-term follow-up of children with neuroblastoma receiving radiotherapy to metastatic lesions within the German Neuroblastoma Trials NB97 and NB 2004

Danny Jazmati et al. Strahlenther Onkol. 2021 Aug.

Abstract

Purpose: Neuroblastoma (NB) is the most common extracranial solid malignancy during childhood. Despite a multimodal treatment approach, the prognosis of patients with metastatic NB is not satisfactory. Although radiotherapy (RT) has become an integral part of treatment of the primary tumor, the role of RT in osteomedullary lesions is not well defined. A retrospective analysis was conducted to evaluate the impact of RT for metastatic sites in children with high-risk NB.

Methods: All patients with stage 4 NB from the prospective, multicenter NB trials NB97 and NB2004 who received RT to metastatic sites during frontline treatment were included in this retrospective analysis.

Results: A total of 18 children were irradiated with a median dose of 36 Gray (Gy; range 20-45 Gy) to one or more (range 1-3) osteomedullary metastases with or without concomitant RT to the primary tumor site. The median follow-up time was 149 months (range 55-220) in survivors. At 5 years, local relapse-free survival (LRFS) at irradiated metastatic sites and metastases-free survival (MFS) at distant, non-irradiated site rates were 51.4 and 39.9%, respectively. The estimated overall survival (OS) rate at 5 years was 49.4%. No high-grade acute or late toxicity and no secondary malignancy was reported.

Conclusion: RT to metastases is feasible for patients with stage 4 NB. However, an impact of RT to residual metastatic sites on outcome was not found. Studies with larger cohorts or prospective trials would be desirable in order to elucidate the role of RT for metastases.

Keywords: Childhood cancer; Clinical trial; Radiation oncology; Stage 4; Survival.

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Conflict of interest statement

D. Jazmati, S. Butzer, B. Hero, J. Doyen, D. Ahmad Khalil, T. Steinmeier, S. Schulze Schleithoff, A. Eggert, T. Simon, and B. Timmermann declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier analysis of local relapse-free survival (a; considering failure at irradiated metastatic sites), metastasis-free survival (b; considering only failure at non-irradiated metastatic sites), and overall survival (c) for the entire cohort
See this image and copyright information in PMC

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