Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma

Barrie S. Rich, Maureen P. McEvoy, Michael P. Laquaglia, Suzanne L. Wolden

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background/Purpose: Patients with locally recurrent or persistent high-risk neuroblastoma are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. Methods: We retrospectively reviewed 44 consecutive patients who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent tumor. Specifically, we evaluated local recurrence rates, complications, and overall survival. Results: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each patient received prior chemotherapy and surgery, while 94.5% had previous external beam radiation therapy. MYCN was amplified in 34% of patients. There were no operative or postoperative deaths, and 18 patients (40.9%) had postoperative complications. There was a 50.4% probability of local control. MYCN amplification did not affect local control (local recurrence rate of 53.9% vs 52.4%, P = .89). Median overall survival was 18.7 months (95% confidence interval, 11.7-25.6 months). Mean survival for MYCN-amplified patients was 13.0 vs 39.2 months for those without MYCN amplification (P = .035). Conclusions: Intraoperative radiation therapy after re-resection of locally recurrent/persistent neuroblastoma results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population.

Original languageEnglish (US)
Pages (from-to)97-101
Number of pages5
JournalJournal of Pediatric Surgery
Volume46
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Neuroblastoma
Radiotherapy
Morbidity
Survival
Mortality
Recurrence
Population
Confidence Intervals
Drug Therapy
Neoplasms

Keywords

  • IORT
  • Neuroblastoma
  • Persistent
  • Recurrent

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma. / Rich, Barrie S.; McEvoy, Maureen P.; Laquaglia, Michael P.; Wolden, Suzanne L.

In: Journal of Pediatric Surgery, Vol. 46, No. 1, 01.01.2011, p. 97-101.

Research output: Contribution to journalArticle

@article{da077c72ba944badb51d765ebfc498d3,
title = "Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma",
abstract = "Background/Purpose: Patients with locally recurrent or persistent high-risk neuroblastoma are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. Methods: We retrospectively reviewed 44 consecutive patients who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent tumor. Specifically, we evaluated local recurrence rates, complications, and overall survival. Results: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each patient received prior chemotherapy and surgery, while 94.5{\%} had previous external beam radiation therapy. MYCN was amplified in 34{\%} of patients. There were no operative or postoperative deaths, and 18 patients (40.9{\%}) had postoperative complications. There was a 50.4{\%} probability of local control. MYCN amplification did not affect local control (local recurrence rate of 53.9{\%} vs 52.4{\%}, P = .89). Median overall survival was 18.7 months (95{\%} confidence interval, 11.7-25.6 months). Mean survival for MYCN-amplified patients was 13.0 vs 39.2 months for those without MYCN amplification (P = .035). Conclusions: Intraoperative radiation therapy after re-resection of locally recurrent/persistent neuroblastoma results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population.",
keywords = "IORT, Neuroblastoma, Persistent, Recurrent",
author = "Rich, {Barrie S.} and McEvoy, {Maureen P.} and Laquaglia, {Michael P.} and Wolden, {Suzanne L.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2010.09.068",
language = "English (US)",
volume = "46",
pages = "97--101",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Local control, survival, and operative morbidity and mortality after re-resection, and intraoperative radiation therapy for recurrent or persistent primary high-risk neuroblastoma

AU - Rich, Barrie S.

AU - McEvoy, Maureen P.

AU - Laquaglia, Michael P.

AU - Wolden, Suzanne L.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background/Purpose: Patients with locally recurrent or persistent high-risk neuroblastoma are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. Methods: We retrospectively reviewed 44 consecutive patients who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent tumor. Specifically, we evaluated local recurrence rates, complications, and overall survival. Results: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each patient received prior chemotherapy and surgery, while 94.5% had previous external beam radiation therapy. MYCN was amplified in 34% of patients. There were no operative or postoperative deaths, and 18 patients (40.9%) had postoperative complications. There was a 50.4% probability of local control. MYCN amplification did not affect local control (local recurrence rate of 53.9% vs 52.4%, P = .89). Median overall survival was 18.7 months (95% confidence interval, 11.7-25.6 months). Mean survival for MYCN-amplified patients was 13.0 vs 39.2 months for those without MYCN amplification (P = .035). Conclusions: Intraoperative radiation therapy after re-resection of locally recurrent/persistent neuroblastoma results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population.

AB - Background/Purpose: Patients with locally recurrent or persistent high-risk neuroblastoma are difficult to treat. We describe our experience using intraoperative radiation therapy (IORT) after re-resection in this high-risk population. Methods: We retrospectively reviewed 44 consecutive patients who received IORT at our institution between April 2000 and September 2009 after gross total resection of recurrent/persistent tumor. Specifically, we evaluated local recurrence rates, complications, and overall survival. Results: The median age at diagnosis was 41.5 months. Median follow-up after IORT was 10.5 months. Each patient received prior chemotherapy and surgery, while 94.5% had previous external beam radiation therapy. MYCN was amplified in 34% of patients. There were no operative or postoperative deaths, and 18 patients (40.9%) had postoperative complications. There was a 50.4% probability of local control. MYCN amplification did not affect local control (local recurrence rate of 53.9% vs 52.4%, P = .89). Median overall survival was 18.7 months (95% confidence interval, 11.7-25.6 months). Mean survival for MYCN-amplified patients was 13.0 vs 39.2 months for those without MYCN amplification (P = .035). Conclusions: Intraoperative radiation therapy after re-resection of locally recurrent/persistent neuroblastoma results in a reasonable rate of local control with acceptable morbidity and survival. This approach should be considered in this high-risk population.

KW - IORT

KW - Neuroblastoma

KW - Persistent

KW - Recurrent

UR - http://www.scopus.com/inward/record.url?scp=78751531104&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78751531104&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2010.09.068

DO - 10.1016/j.jpedsurg.2010.09.068

M3 - Article

VL - 46

SP - 97

EP - 101

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 1

ER -