Sistema de Salut de Catalunya
Institut Català de la Salut
[Huijskens SC, Kroon PS] Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. [Gaze MN] Department of Oncology, University College London Hospitals, London, UK. [Gandola L] Paediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Bolle S] Department of Radiation Oncology, Gustave Roussy, Villejuif, France. [Supiot S] Oncologie Radiotherapie, Institut de Cancérologie de l’Ouest, Nantes, France. [Giralt J] Servei d’Oncologia Radioteràpica, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2021-07-06T12:12:40Z
2021-07-06T12:12:40Z
2021-03-01
Metàstasis; Pediatria; Radioteràpia
Metástasis; Pediatría; Radioterapia
Metastases; Paediatrics; Radiotherapy
Purpose/objective About 20% of children with solid tumours (ST) present with distant metastases (DM). Evidence regarding the use of radical radiotherapy of these DM is sparse and open for personal interpretation. The aim of this survey was to review European protocols and to map current practice regarding the irradiation of DM across SIOPE-affiliated countries. Materials/methods Radiotherapy guidelines for metastatic sites (bone, brain, distant lymph nodes, lung and liver) in eight European protocols for rhabdomyosarcoma, non-rhabdomyosarcoma soft-tissue sarcoma, Ewing sarcoma, neuroblastoma and renal tumours were reviewed. SIOPE centres irradiating ≥50 children annually were invited to participate in an online survey. Results Radiotherapy to at least one metastatic site was recommended in all protocols, except for high-risk neuroblastoma. Per protocol, dose prescription varied per site, and information on delineation and treatment planning/delivery was generally missing. Between July and September 2019, 20/27 centres completed the survey. Around 14% of patients were deemed to have DM from ST at diagnosis, of which half were treated with curative intent. A clear cut-off for a maximum number of DM was not used in half of the centres. Regardless of the tumour type and site, conventional radiotherapy regimens were most commonly used to treat DM. When stereotactic radiotherapy was used, a wide range of fractionation regimens were applied. Conclusion Current radiotherapy guidelines for DM do not allow a consistent approach in a multicentre setting. Prospective (randomised) trials are needed to define the role of radical irradiation of DM from paediatric ST.
Stichting Kinderen Kankervrij [project no. 343]. KiKa (Children Cancer Free) foundation, grant number 343 and title: Towards optimization of radiotherapy techniques for metastatic lesions in children stage IV disease. The funding source had no role in the study design, collection, analysis and interpretation of data, writing of this manuscript or the decision to submit the article for publication.
Article
Published version
English
Metàstasi; Càncer - Radioteràpia; Avaluació de resultats (Assistència sanitària); DISEASES::Neoplasms::Neoplastic Processes::Neoplasm Metastasis; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Radiotherapy; PUBLIC HEALTH::Epidemiology and Biostatistics::Epidemiology::Uses of Epidemiology::Evaluation of Results of Therapeutic Interventions; ENFERMEDADES::neoplasias::procesos neoplásicos::metástasis neoplásica; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::radioterapia; SALUD PÚBLICA::epidemiología y bioestadística::epidemiología::usos de la epidemiología::evaluación del resultado de intervenciones terapéuticas
Elsevier
European Journal of Cancer;145
https://linkinghub.elsevier.com/retrieve/pii/S0959804920314167
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3439]
