Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience)

Chen, Yi-Wei; Wong, Tai-Tong; Ho, Donald Ming-Tak; Huang, Pin-I.; Chang, Kai-Ping; Shiau, Cheng-Ying; Yen, Sang-Hue

doi:10.1016/j.ijrobp.2005.10.001

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Volume 64, Issue 4 , Pages 1038-1043, 15 March 2006

Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience)

This paper was presented in 2004 at the Third Asian Society for Neuro-Oncology, an international symposium in Shanghai, China.

Yi-Wei Chen, M.D.
- Cancer Center, Neurological Institute, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Tai-Tong Wong, M.D.
- Division of Pediatric Neurosurgery, Neurological Institute, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
Donald Ming-Tak Ho, M.D.
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
Pin-I. Huang, M.D.
- Cancer Center, Neurological Institute, Taipei, Taiwan
Kai-Ping Chang, M.D.
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
Cheng-Ying Shiau, M.D.
- Cancer Center, Neurological Institute, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
Sang-Hue Yen, M.D.
- Cancer Center, Neurological Institute, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Reprint requests to: Sang-Hue Yen, M.D., Cancer Center, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan. Tel: (+886) 2-28757469; Fax: (+886) 2-28749425

Received 15 July 2005; received in revised form 6 October 2005; accepted 10 October 2005. published online 05 January 2006.

Purpose: To assess outcomes and prognostic factors in radiotherapy of pediatric central nervous system atypical teratoid/rhabdoid tumor (AT/RT).

Methods and Materials: Seventeen patients with central nervous system AT/RT were retrospectively reviewed after curative radiotherapy as primary or adjuvant therapy between January 1990 and December 2003. Overall and failure-free survival rates were calculated using the Kaplan–Meier method. The log–rank method was used to compare the effects of dosage (>50 Gy or ≤50 Gy) and treatment duration (>45 days or ≤45 days). Multivariate analysis was performed for prognostic factors.

Results: Median overall survival and failure-free survival were 17 and 11 months, respectively. The 3 longest-surviving patients were older, underwent gross tumor removal, and completed both craniospinal and focal boost irradiation. Multivariate analysis revealed a significant relationship between the following: overall survival and performance status (p = 0.019), failure-free survival and total irradiation dose (p = 0.037), time interval between surgery and radiotherapy initiation (p = 0.031), and time interval between surgery and radiotherapy end point (p = 0.047).

Conclusion: Radiotherapy is crucial in the treatment of AT/RT. We recommend initiating radiotherapy immediately postoperatively and before systemic chemotherapy in pediatric patients ≥3 years of age.

Keywords: Atypical teratoid/rhabdoid tumor , Brain neoplasm , Radiotherapy , Craniospinal irradiation , Combined modality therapy