Taylor, R. E., Donachie, P. H. J., Weston, C. L., Robinson, K. J., Lucraft, H., Saran, F., Ellison, D. W., Ironside, J., Walker, D. A., Pizer, B. L., Children's Cancer Leukaemia Group CCLG, [Group Author] (2009) Impact of radiotherapy parameters on outcome for patients with supratentorial primitive neuro-ectodermal tumours entered into the SIOP/UKCCSG PNET 3 study. RADIOTHERAPY AND ONCOLOGY, 92 (1). pp. 83-88. ISSN 0167-8140

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Abstract

Background and purpose: To evaluate the impact of radiotherapy (RT) parameters on outcome in the SIOP/UKCCSG study of pre-RT chemotherapy for Supratentorial Primitive Neuro-ectodermal Tumours. Methods and materials: Sixty-two patients aged 2.9-16.6 (median 6.4 years) were eligible. Forty-eight (77%) had non-pineal sites and 14 (23%) had pineal sites. Eleven were randomized to RT alone (6) and five to pre-RT Vincristine, Etoposide, Carboplatin and Cyclophosphamide. Fifty-one were not randomized, 15 receiving RT alone and 36 receiving pre-RT chemotherapy. Craniospinal RT (CSRT) 35 Gy/21 fractions were followed by 20 Gy/12 fractions to primary tumour. Results: Mean CSRT dose was 34.7 Gy and mean total primary dose was 53.4 Gy for those who received radiotherapy. Of 30 relapses, 18 (60%) were local only and 5 (16.7%) were combined local and leptomeningeal. There was no significant impact on Overall Survival (OS) or Event-Free Survival (EFS) of surgery-RT interval for patients treated by pre-RT chemotherapy or RT alone, or duration of RT (completing within 50 days). Planning films were received for 42/54 (77.8%) patients. Fourteen (33%) had one or more targeting deviations (10 cribriform fossa, 11 base of skull). There was a statistically significant increase in the risk of recurrence for patients with cribriform fossa targeting deviations (p = 0.033), but not for patients with base of skull targeting deviations (p = 0.242). There was no statistically significant difference in OS (p = 0.0598) OF EFS (p = 0.0880) for patients who had one or more targeting deviations compared to those who had none. Conclusions: This study has not demonstrated a statistically significant impact of radiotherapy duration or targeting deviations on OS or EFS, possibly due to small patient numbers. However, multi-institutional SPNET trials should incorporate quality assurance programs including analysis of relapse pattern in relation to primary target Volume coverage. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 92 (2009) 83-88

Item Type:	Article
All Authors:	Taylor, R. E., Donachie, P. H. J., Weston, C. L., Robinson, K. J., Lucraft, H., Saran, F., Ellison, D. W., Ironside, J., Walker, D. A., Pizer, B. L., Children's Cancer Leukaemia Group CCLG, [Group Author]
Uncontrolled Keywords:	Supratentorial primitive neuro-ectodermal tumour; Radiotherapy; Recurrence; Survival; Quality assurance;PEDIATRIC-ONCOLOGY SIOP; INTERNATIONAL-SOCIETY; NEUROECTODERMAL TUMORS; PRERADIATION CHEMOTHERAPY; CRANIOSPINAL IRRADIATION; ADJUVANT CHEMOTHERAPY; QUALITY-CONTROL; BRAIN-TUMORS; MEDULLOBLASTOMA; CHILDREN
Funding Acknowledgement:	Cancer Research UK ; Samantha Dickson Brain Turnout-Trust
Funding Text:	We wish to acknowledge the contribution of the following for their input into the development of the protocol - Statistics: Mr. J. Imeson; Neurosurgery: Mr. M. Cameron, Professor W. Entziam Chemotherapy: Prof A.D.J. Pearson; Pathology: Dr. P. Kleihues: Radiodiagnosis: Dr. W. St. Clair Forbes, Dr. D. Diebler; Radiotherapy: Dr. J.M.V. Burgers, Prof. E.M. Rottinger; Psychology: Mr. J. Cadranel. We wish to acknowledge the support of the Cancer Research UK and the Samantha Dickson Brain Turnout-Trust in carrying out this study, and the staff of the CCLG for conducting the trial.
Research teams:	Clinical Units > Neuro-oncology Unit
Depositing User:	Users 10 not found.
Date Deposited:	27 Jul 2009 14:02
Last Modified:	21 Oct 2009 15:39
URI:	http://publications.icr.ac.uk/id/eprint/8450

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