19 Harley St, London, W1G 9QJ, UK

Intensity-Modulated Radiation Therapy With Dose-Painting for Pediatric Sarcomas With Pulmonary Metastases.

Intensity-Modulated Radiation Therapy With Dose-Painting for Pediatric Sarcomas With Pulmonary Metastases.

Pediatr Blood Cancer. 2013 Jun 13;

Authors: Yang JC, Wexler LH, Meyers PA, Happersett L, La Quaglia MP, Wolden SL

BACKGROUND: We examined patterns of failure in pediatric patients with thoracic sarcoma and pulmonary metastases treated with intensity-modulated radiation therapy with dose-painting (DP-IMRT). PROCEDURE: Eleven pediatric patients, five with Ewing sarcoma family tumors (ESFT) and six with rhabdomyosarcoma (RMS), with primary thoracic tumors and pulmonary metastases underwent DP-IMRT with chemotherapy for definitive treatment. Eight patients also underwent surgery. Median time to RT was 21 (15-31) weeks. Nine patients received 45-50.4-Gy in 1.8?Gy fractions to the primary tumor (n?=?3) or post-operative tumor bed (n?=?6). Two patients ?4 years received 12?Gy intraoperative radiation therapy and 30.6-36?Gy IMRT postoperatively to the tumor bed. All patients received 14-16.8?Gy in 0.54-0.88?Gy fractions to the whole lungs (n?=?6) or hemithorax (n?=?5) using dose-painting technique. A representative case was re-planned with IMRT plus standard AP/PA whole lung irradiation (WLI) for dosimetric comparison. RESULTS: With 27-month median follow-up, 3-year pulmonary relapse-free survival in all patients was 61%: 80% for RMS and 40% for ESFT. Five patients (4 ESFT and 1 RMS) experienced pulmonary relapse at median 16 (9-41) months. There were no local failures. Our representative case demonstrated more homogeneous target volume coverage of the whole lungs and decreased mean dose to esophagus (15%), heart (31%), spinal cord (15%), and liver (19%) with DP-IMRT. CONCLUSIONS: The treatment of children with a primary thoracic tumor and pulmonary metastases poses a significant challenge. DP-IMRT is one solution to this technical problem. Initial data from this small series suggest DP-IMRT is feasible and produces superior sparing of critical normal tissues. Pediatr Blood Cancer 2013;9999:XX-XX. © 2013 Wiley Periodicals, Inc.

PMID: 23765910 [PubMed – as supplied by publisher]

Intensity-Modulated Radiation Therapy With Dose-Painting for Pediatric Sarcomas With Pulmonary Metastases | Best medicine for nerve pain

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

Revolutionary Keyhole surgical technique to vaporise bulging discs

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
Treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function.

UK's Leading Spine Surgeon

Mr Mo Akmal has developed revolutionary techniques to perform Day Case Spinal Surgery. We avoid traditional General Anaesthetic for all surgery.

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services.

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810