Advertisement

Pediatric Cancer

  • Arnold C. PaulinoEmail author
Chapter
  • 31 Downloads
Part of the Medical Radiology book series (MEDRAD)

Abstract

Current strategies in pediatric oncology have utilized an approach which balances the probability of cure and risk of acute and late toxicity from treatment. This chapter will discuss some of the recent development in pediatric radiation oncology and explores the different strategies that have been utilized, Many of the strategies have decreased either dose or volume of radiotherapy; however, in certain scenarios, the role of radiotherapy has expanded to include treatment of young children < 3 years with brain tumors, treatment of metastatic disease as part of initial therapy and use of reirradiation.

References

  1. Alapetite C, Brisse H, Patte C et al (2010) Pattern of relapse and outcome of non-metastatic germinoma patients treated with chemotherapy and limited field radiation: the SFOP experience. Neuro Oncol 12:1318–1325PubMedPubMedCentralGoogle Scholar
  2. Ashley DM, Merchant TE, Strother D et al (2012) Induction chemotherapy and conformal radiation therapy for very young children with nonmetastatic medulloblastoma: Children’s Oncology Group study P9934. J Clin Oncol 30:3181–3186CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bakst RL, Dunkel IJ, Gilheeney S et al (2011) Reirradiation for recurrent medulloblastoma. Cancer 117:4977–4982CrossRefPubMedPubMedCentralGoogle Scholar
  4. Balmaceda C, Heller G, Rosenblum M et al (1996) Chemotherapy without irradiation – a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. J Clin Oncol 14:2908–2915CrossRefPubMedPubMedCentralGoogle Scholar
  5. Bishop AJ, Greenfield B, Mahajan A et al (2014) Proton beam therapy versus conformal photon radiation therapy for childhood craniopharyngioma: multi-institutional analysis of outcomes, cyst dynamics, and toxicity. Int J Radiat Oncol Biol Phys 90:354–361CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bouffet E, Hawkins CE, Ballourah W et al (2012) Survival benefit for pediatric patients with recurrent ependymoma treated with reirradiation. Int J Radiat Oncol Biol Phys 83:1541–1548CrossRefPubMedPubMedCentralGoogle Scholar
  7. Breneman J, Meza J, Donaldson SS et al (2011) Local control with reduced-dose radiotherapy for low-risk rhabdomyosarcoma: a report from the Children’s Oncology Group D9602 study. Int J Radiat Oncol Biol Phys 83:720–726CrossRefPubMedPubMedCentralGoogle Scholar
  8. Casey DL, Friedman DN, Moskowitz CS et al (2014) Second cancer risk in childhood cancer survivors treated with intensity modulated radiation therapy (IMRT). Pediatr Blood Cancer 62:445–449Google Scholar
  9. Castellino S, Keller F, Voss S et al (2014) Outcomes and patterns of failure in children/adolescents with low-risk Hodgkin lymphoma (HL) who are FDG-PET (PET3) positive after AVPC therapy. Kin Padiatr 226:O-06 (abstract)Google Scholar
  10. Crist WM, Anderson JR, Meza JL et al (2001) Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. J Clin Oncol 19:3091–3102CrossRefGoogle Scholar
  11. Curtis AE, Okcu MF, Chintagumpala M et al (2009) Local control after intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma. Int J Radiat Oncol Biol Phys 73:173–177CrossRefGoogle Scholar
  12. Da Silva NS, Cappellano AM, Diez B et al (2010) Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study. Pediatr Blood Cancer 54:377–383CrossRefGoogle Scholar
  13. De Kraker J, Lemerle J, Voute PA et al (1990) Wilms’ tumor with pulmonary metastases at diagnosis: the significance of primary chemotherapy. International Society of Pediatric Oncology Nephroblastoma Trial and Subcommittee. J Clin Oncol 8:1187–1190CrossRefGoogle Scholar
  14. Dix DB, Gratias EJ, Seibel N et al (2014) Treatment of stage IV favorable histology Wilms tumor with incomplete lung metastasis response after chemotherapy: a report from Children’s Oncology Group study AREN0533. J Clin Oncol 32:5s (abstr 10001)Google Scholar
  15. Dorffel W, Ruhl U, Luders H et al (2013) Treatment of children and adolescents with Hodgkin lymphoma without radiotherapy for patients in complete remission after chemotherapy: final results of the multinational trial GPOH-HD95. J Clin Oncol 31:1562–1568CrossRefGoogle Scholar
  16. Douglas JG, Barker JL, Ellenbogen RG et al (2004) Concurrent chemotherapy and reduced-dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average-risk medulloblastoma: efficacy and patterns of failure. Int J Radiat Oncol Biol Phys 58:1161–1164CrossRefGoogle Scholar
  17. Duffner PK, Horowitz ME, Krischer JP et al (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 328:1725–1731CrossRefPubMedPubMedCentralGoogle Scholar
  18. Eaton BR, Chowdhry V, Weaver K et al (2015) Use of proton therapy for re-irradiation in pediatric intracranial ependymoma. Radiother Oncol 116:301–308CrossRefPubMedPubMedCentralGoogle Scholar
  19. Fontanilla HP, Pinnix CC, Ketonen LM et al (2012) Palliative reirradiation for progressive diffuse intrinsic pontine glioma. Am J Clin Oncol 35:51–57CrossRefGoogle Scholar
  20. Friedman DL, Chen L, Wolden S et al (2014) Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly-diagnosed intermediate-risk Hodgkin lymphoma: a report from the Children’s Oncology Group study AHOD0031. J Clin Oncol 32:3651–3658CrossRefPubMedPubMedCentralGoogle Scholar
  21. Gillis AM, Sutton E, Dewitt KD et al (2007) Long-term outcome and toxicities of intraoperative radiotherapy for high-risk neuroblastoma. Int J Radiat Oncol Biol Phys 69:858–864CrossRefGoogle Scholar
  22. Goldwein JW, Radcliffe J, Johnson J et al (1996) Updated results of a pilot study of low dose craniospinal irradiation plus chemotherapy for children under five with cerebellar primitive neuroectodermal tumors (medulloblastoma). Int J Radiat Oncol Biol Phys 34:899–904CrossRefGoogle Scholar
  23. Green DM, Breslow NE, Beckwith JB et al (1998) Effect of duration of treatment on treatment outcome and cost of treatment for Wilms’ tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol 16:3744–3751CrossRefGoogle Scholar
  24. Greenfield BJ, Okcu MF, Baxter PA et al (2015) Long-term disease control and toxicity outcomes following surgery and intensity-modulated radiation therapy (IMRT) in pediatric craniopharyngioma. Radiother Oncol 114:224–229CrossRefGoogle Scholar
  25. Grill J, De Ley MC, Gambarelli D et al (2001) Postoperative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multicenter trial of the French Society of Pediatric Oncology. J Clin Oncol 19:1288–1296CrossRefGoogle Scholar
  26. Grundy PE, Green DM, Dirks AC et al (2012) Clinical significance of pulmonary nodules detected by CT and not CXR in patients treated for favorable histology Wilms tumor studies −4 and −5: a report from the Children’s Oncology Group. Pediatr Blood Cancer 59:631–635CrossRefPubMedPubMedCentralGoogle Scholar
  27. Guckenberger M, Mantel F, Gerszten PC et al (2014) Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis. Radiat Oncol 9:226CrossRefPubMedPubMedCentralGoogle Scholar
  28. Haas-Kogan DA, Swift PS, Selch M et al (2003) Impact of radiotherapy for high-risk neuroblastoma: a Children’s Cancer Group study. Int J Radiat Oncol Biol Phys 56:28–39CrossRefGoogle Scholar
  29. Hall EJ, Wuu CS (2003) Radiation-induced second cancers: 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys 56:83–88CrossRefPubMedPubMedCentralGoogle Scholar
  30. Jakacki RI, Feldman H, Jamison C et al (2004) A pilot study of preirradiation chemotherapy and 1800 cGy craniospinal irradiation in young children with medulloblastoma. Int J Radiat Oncol Biol Phys 60:531–536CrossRefPubMedPubMedCentralGoogle Scholar
  31. Kellie SJ, Boyce H, Dunkel IJ et al (2004) Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach. Pediatr Blood Cancer 43:126–133CrossRefPubMedPubMedCentralGoogle Scholar
  32. Kushner BH, Wolden S, LaQuaglia MP et al (2001) Hyperfractionated low-dose radiotherapy for high-risk neuroblastoma after intensive chemotherapy and surgery. J Clin Oncol 19:2821–2828CrossRefPubMedPubMedCentralGoogle Scholar
  33. Ladra MM, Szymonifka JD, Mahajan A et al (2014) Preliminary results of a phase II trial of proton radiotherapy for pediatric rhabdomyosarcoma. J Clin Oncol 32:3762–3770CrossRefPubMedPubMedCentralGoogle Scholar
  34. Macdonald SM, Sethi R, Lavally B et al (2013) Proton radiotherapy for pediatric central nervous system ependymoma: clinical outcomes for 70 patients. Neuro Oncol 15:1552–1559CrossRefPubMedPubMedCentralGoogle Scholar
  35. Mandell L, Ghavimi F, Peretz T et al (1990) Radiocurability of microscopic disease in childhood rhabdomyosarcoma with radiation doses less than 4000 cGy. J Clin Oncol 8:1536–1542CrossRefPubMedPubMedCentralGoogle Scholar
  36. Mazloom A, Louis CU, Nuchtern J et al (2014) Radiation therapy to the primary and postinduction chemotherapy MIBG-avid sites in high-risk neuroblastoma. Int J Radiat Oncol Biol Phys 90:858–862CrossRefPubMedPubMedCentralGoogle Scholar
  37. Merchant TE, Davis BJ, Sheldon JM et al (1998) Radiation therapy for relapsed CNS germinoma after primary chemotherapy. J Clin Oncol 16:204–209CrossRefPubMedPubMedCentralGoogle Scholar
  38. Merchant TE, Boop FA, Kun LE et al (2008) A retrospective study of surgery and reirradiation for recurrent ependymoma. Int J Radiat Oncol Biol Phys 71:87–97CrossRefPubMedPubMedCentralGoogle Scholar
  39. Merchant TE, Li C, Xiong X et al (2009) Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol 10:258–266CrossRefPubMedPubMedCentralGoogle Scholar
  40. Merchant TE, Bendel AE, Sabin N et al (2015) A Phase II trial of conformal radiation therapy for pediatric patients with localized ependymoma, chemotherapy prior to second surgery for incompletely resected ependymoma and observation for completely resected, differentiated, supratentorial ependymoma. Int J Radiat Oncol 93(3S):S1 (abstract)Google Scholar
  41. Messahel B, Ashley S, Saran F et al (2009) Relapsed intracranial ependymoma in children in the UK: patterns of relapse, survival and therapeutic outcome. Eur J Cancer 45:1815–1823CrossRefPubMedPubMedCentralGoogle Scholar
  42. Miralbell R, Lomax A, Cella L et al (2002) Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumors. Int J Radiat Oncol Biol Phys 54:824–829CrossRefPubMedPubMedCentralGoogle Scholar
  43. Moxon-Emre I, Bouffet E, Taylor MD et al (2014) Impact of craniospinal dose, boost volume, and neurologic complications on intellectual outcome in patients with medulloblastoma. J Clin Oncol 32:1760–1768CrossRefPubMedPubMedCentralGoogle Scholar
  44. Nachman JB, Sposto R, Herzog P et al (2002) Randomized comparison of low-dose involved field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 20:3765–3771CrossRefPubMedPubMedCentralGoogle Scholar
  45. Owens CM, Veys PA, Pritchard J et al (2002) Role of chest computed tomography at diagnosis in the management of Wilms’ tumor: a study by the United Kingdom Children’s Cancer Study Group. J Clin Oncol 20:2768–2773CrossRefPubMedPubMedCentralGoogle Scholar
  46. Paulino AC, Lobo M, Teh BS et al (2010) Ototoxicity after intensity-modulated radiation therapy and cisplatin-based chemotherapy in children with medulloblastoma. Int J Radiat Oncol Biol Phys 78:1445–1450CrossRefPubMedPubMedCentralGoogle Scholar
  47. Paulino AC, Mazloom A, Teh BS et al (2011) Local control after craniospinal irradiation, intensity-modulated radiation therapy boost, and chemotherapy in childhood medulloblastoma. Cancer 117:635–641CrossRefPubMedPubMedCentralGoogle Scholar
  48. Paulino AC, Mazloom A, Terashima K et al (2013a) Intensity-modulated radiotherapy (IMRT) in pediatric low grade glioma. Cancer 119:2654–2659CrossRefPubMedPubMedCentralGoogle Scholar
  49. Paulino AC, Mai WY, Teh BS (2013b) Radiotherapy in metastatic Ewing sarcoma. Am J Clin Oncol 36:283–286CrossRefGoogle Scholar
  50. Pratt CB, Pappo AS, Gieser P et al (1999) Role of adjuvant chemotherapy in the treatment of surgically resected pediatric nonrhabdomyosarcomatous soft tissue sarcomas: a Pediatric Oncology Group Study. J Clin Oncol 17:1219CrossRefGoogle Scholar
  51. Rogers SJ, Mosleh-Shirazi MA, Saran FH (2005) Radiotherapy of localized intracranial germinoma: time to sever historical ties. Lancet Oncol 6:509–519CrossRefGoogle Scholar
  52. Rutkowski S, Bode U, Deinlein F et al (2005) Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med 352:978–986CrossRefGoogle Scholar
  53. Sahgal A, Ames C, Chou D et al (2009) Stereotactic body radiotherapy is effective salvage therapy for patients with prior radiation of spinal metastases. Int J Radiat Oncol Biol Phys 74:723–731CrossRefGoogle Scholar
  54. Schroeder TM, Chintagumpala M, Okcu MF et al (2008) Intensity-modulated radiation therapy in childhood ependymoma. Int J Radiat Oncol Biol Phys 71:987–993CrossRefGoogle Scholar
  55. Sethi RV, Shih HA, Yeap BY et al (2014) Second nonocular tumors among survivors of retinoblastoma treated with contemporary photon and proton radiotherapy. Cancer 120:126–133CrossRefGoogle Scholar
  56. Simon T, Hero B, Bongartz R et al (2006) Intensified external-beam radiation therapy improves the outcome of stage 4 neuroblastoma in children > 1 year with residual local disease. Strahlenther Onkol 182:389–394CrossRefGoogle Scholar
  57. Spunt SL, Poquette CA, Hurt YS et al (1999) Prognostic factors for children and adolescents with surgically resected nonrhabdomyosarcoma soft tissue sarcoma: an analysis of 121 patients treated at St Jude Children’s Research Hospital. J Clin Oncol 17:3697–3705CrossRefGoogle Scholar
  58. Spunt SL, Million L, Anderson JR et al (2014) Risk-based treatment for Nonrhabdomyosarcoma soft tissue sarcomas (NRSTS) in patients under 30 years of age: Children’s Oncology Group study ARST0332. J Clin Oncol 23:5s (abstr 10008)Google Scholar
  59. Van Bueren AO, von Hoff K, Pietsch T et al (2011) Treatment of young children with localized medulloblastoma by chemotherapy alone: results of the prospective multicenter trial HIT 2000 confirming the prognostic impact of histology. Neuro Oncol 13:669–679CrossRefGoogle Scholar
  60. Wetmore C, Herington D, Lin T et al (2014) Reirradiation of recurrent medulloblastoma. Cancer 120:3731–3737CrossRefPubMedPubMedCentralGoogle Scholar
  61. Wilimas JA, Douglass EC, Magill HL et al (1988) Significance of pulmonary computed tomography at diagnosis in Wilms’ tumor. J Clin Oncol 6:1144–1146CrossRefGoogle Scholar
  62. Wilimas JA, Kaste SC, Kauffman WM et al (1997) Use of chest computed tomography in the staging of pediatric Wilms’ tumor: interobserver variability and prognostic significance. J Clin Oncol 15:2631–2635CrossRefGoogle Scholar
  63. Wolden SL, Dunkel IJ, Souweidane MM et al (2003) Patterns of failure using a conformal radiation therapy tumor bed boost for medulloblastoma. J Clin Oncol 21:3079–3083CrossRefGoogle Scholar
  64. Yang JC, Dharmarajan KV, Wexler LH et al (2012) Intensity modulated radiation therapy with dose painting to treat rhabdomyosarcoma. Int J Radiat Oncol Biol Phys 84:e371–e377CrossRefGoogle Scholar
  65. Zhang R, Howell RM, Taddei PJ et al (2014) A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation. Radiother Oncol 113:84–88CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 2.5 International License (http://creativecommons.org/licenses/by-nc/2.5/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Authors and Affiliations

  1. 1.Department of Radiation OncologyPediatric Radiation Oncology Fellowship Director, MD Anderson Cancer CenterHoustonUSA

Personalised recommendations