Clinical impact of hypothalamic‐pituitary disorders after conformal radiation therapy for pediatric low‐grade glioma or ependymoma

2020 ◽  
Vol 67 (12) ◽  
Author(s):  
Laura Iersel ◽  
Hanneke M. Santen ◽  
Brian Potter ◽  
Zhenghong Li ◽  
Heather M. Conklin ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Clinical Impact ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Conformal Radiation Therapy

scholarly journals Phase II Trial of Conformal Radiation Therapy for Pediatric Low-Grade Glioma

2009 ◽  
Vol 27 (22) ◽  
pp. 3598-3604 ◽  
Author(s):  
Thomas E. Merchant ◽  
Larry E. Kun ◽  
Shengjie Wu ◽  
Xiaoping Xiong ◽  
Robert A. Sanford ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Disease Control ◽  
Phase Ii ◽  
Standard Error ◽  
Phase Ii Trial ◽  
Young Patients ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Conformal Radiation Therapy ◽  
The Mean

Purpose The use of radiotherapy in pediatric low-grade glioma (LGG) is controversial, especially for young patients. We conducted a phase II trial of conformal radiation therapy (CRT) to estimate disease control by using a 10-mm clinical target volume (CTV) margin. Materials and Methods Between August 1997 and August 2006, 78 pediatric patients with LGG and a median age of 8.9 years (range, 2.2 to 19.8 years) received 54 Gy CRT by using a 10-mm CTV and by targeting with systematic magnetic resonance imaging (MRI) registration. Tumor locations were diencephalon (n = 58), cerebral hemisphere (n = 3), and cerebellum (n = 17). Sixty-seven patients had documented or presumed WHO grade 1 tumors, 25 patients had prior chemotherapy, and 13 patients had neurofibromatosis type 1. Results During a median follow-up of 89 months, 13 patients experienced disease progression. One patient experienced marginal treatment failure, eight experienced local failures, and four experienced metastatic failure. The mean and standard error 5- and 10-year event-free (87.4% ± 4.4% and 74.3% ± 15.4%, respectively) and overall (98.5% ± 1.6% and 95.9% ± 5.8%, respectively) survival rates were determined. The mean and standard error cumulative incidences of local failure at 5 and 10 years were 8.7% ± 3.5% and 16.4% ± 5.4%, respectively. The mean and standard error cumulative incidence of vasculopathy was 4.79% ± 2.73% at 6 years, and it was higher for those younger than 5 years of age (P = .0105) at the time of CRT. Conclusion This large, prospective series of irradiated children with LGG demonstrates that CRT with a 10-mm CTV does not compromise disease control. The results suggest that CRT should be delayed in young patients to reduce the risk of vasculopathy.

scholarly journals SAT-457 Hypothalamic-Pituitary Disorders after Conformal Radiation Therapy for Childhood and Young Adult Low-Grade Glioma or Ependymoma

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Laura van Iersel ◽  
Hanneke van Santen ◽  
Brian Potter ◽  
Zhenghong Li ◽  
Heather Conklin ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Young Adult ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Conformal Radiation Therapy

scholarly journals Late Effects of Conformal Radiation Therapy for Pediatric Patients With Low-Grade Glioma: Prospective Evaluation of Cognitive, Endocrine, and Hearing Deficits

2009 ◽  
Vol 27 (22) ◽  
pp. 3691-3697 ◽  
Author(s):  
Thomas E. Merchant ◽  
Heather M. Conklin ◽  
Shengjie Wu ◽  
Robert H. Lustig ◽  
Xiaoping Xiong
Keyword(s):  
Radiation Therapy ◽  
Radiation Dose ◽  
Late Effects ◽  
Cumulative Incidence ◽  
Pediatric Patients ◽  
Low Grade Glioma ◽  
Endocrine Function ◽  
Low Grade ◽  
Normal Brain ◽  
Conformal Radiation Therapy

Purpose We conducted a prospective trial to evaluate late effects in pediatric patients with low-grade glioma (LGG) treated with conformal radiation therapy (CRT). Patients and Methods Between August 1997 and August 2006, 78 pediatric patients with LGG (mean age, 9.7 years; standard deviation, ±4.4 years) received 54 Gy of CRT with a 10-mm clinical target volume margin. Tumor locations were diencephalon (n = 58), cerebral hemisphere (n = 3), and cerebellum (n = 17). Baseline and serial evaluations were performed to identify deficits in cognition, endocrine function, and hearing. Deficits were correlated with clinical factors and radiation dose within specific normal tissue volumes. Results Cognitive effects of CRT through 5 years after CRT correlated with patient age, neurofibromatosis type 1 status, tumor location and volume, extent of resection, and radiation dose. The effect of age exceeded that of radiation dose; patients younger than 5 years experienced the greatest decline in cognition. Before CRT, growth hormone (GH) secretion abnormality was diagnosed in 24% of tested patients, and 12% had precocious puberty. The 10-year cumulative incidence of GH replacement was 48.9%; of thyroid hormone replacement, 64.0%; of glucocorticoid replacement, 19.2%; and of gonadotropin-releasing hormone analog therapy, 34.2%. The mean ± standard errors of the cumulative incidence of hearing loss at 10 years did not exceed 5.7% ± 3.3% at any frequency. Conclusion To our knowledge, this is the largest series of prospectively followed children with LGG to undergo irradiation. Adverse effects are limited and predictable for most patients; however, this study provides additional evidence that CRT should be delayed for young patients and identifies the potential benefits of reducing radiation dose to normal brain.

Stereotactic conformal radiation therapy in the treatment of benign and low-grade brain tumors

2017 ◽  
Vol 6 (S7) ◽  
pp. S1200-S1204
Author(s):  
James D. Byrne ◽  
Trevor J. Royce ◽  
Jay S. Loeffler
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Low Grade ◽  
Conformal Radiation Therapy
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