Publications Repository

Publications Repository

View item 
  •   Home
  • ICR Divisions
  • Radiotherapy and Imaging
  • View item
  • Home
  • ICR Divisions
  • Radiotherapy and Imaging
  • View item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Impact of induction chemotherapy, hyperfractionated accelerated radiotherapy and high-dose thiotepa on brain volume loss and functional status of children with primitive neuroectodermal tumour

Thumbnail
Date
2017
ICR Author
Szychot, Elwira
Type
Journal Article
Metadata
Show full item record
Abstract
Background: The introduction of aggressive chemo-radiotherapy regimens has improved overall survival in children with primitive neuroectodermal tumours (PNET). However, these combinations may result in neurotoxicity. Previously reported magnetic resonance imaging abnormalities in children receiving intensive sequential chemotherapy, hyperfractionated accelerated radiotherapy (HART) and high-dose thiotepa prompted us to investigate the degree of brain volume loss and patients' functional status after therapy. Methods: We retrospectively reviewed clinico-radiological data of children with PNET treated in this way at our centre. Results: We studied 14 children treated between December 2009 and April 2013. Data were not complete for one child. Performance status was severely restricted in four children, and mildly to moderately impaired in 7 of the 13 children. Eleven of 13 children showed mild-to-severe generalised neuroparenchymal atrophy, in 7 of whom neuroparenchymal volume loss was moderate to severe. Of these seven, six had received high-dose thiotepa. There was no correlation between brain volume loss and Lansky performance status. However, unexpected neurotoxicities, such as symptoms of transverse myelitis, were observed. Conclusion: Measurement of brain volume loss in patients treated with HART and high-dose thiotepa may not be sufficient to predict function. However, correlation of brain volume loss due to late neurotoxicity with performance decline may be more obvious over longer period of follow-up. The combination of HART and myeloablative courses of thiotepa is associated with severe neurotoxicity and subsequent decline in performance status in a significant proportion of patients.
URI
https://repository.icr.ac.uk/handle/internal/2000
Collections
  • Radiotherapy and Imaging
Subject
brain volume chemotherapy Lansky medulloblastoma radiotherapy central-nervous-system corpus-callosum white-matter magnetic-resonance craniospinal radiotherapy maintenance chemotherapy risk medulloblastoma radiation-therapy classification irradiation Oncology Hematology Pediatrics
Research team
Magnetic Resonance
Language
eng
License start date
2017
Citation
PEDIATRIC BLOOD & CANCER, 2017, 64 (11)

Browse

All of ICR repositoryICR DivisionsBy issue dateAuthorsTitlesPublication TypesThis collectionBy issue dateAuthorsTitlesPublication Types
  • Login
  • Registered office: The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP
    A Charity, Not for Profit. Company Limited by Guarantee.
    Registered in England No. 534147. VAT Registration No. GB 849 0581 02.