Clinical outcomes and efficacy of stereotactic body radiation therapy in children, adolescents, and young adults with metastatic solid tumors

• Main Authors: Aldrink, J. (Author), Baliga, S. (Author), Cadieux, C. (Author), Cetnar, A. (Author), Cripe, T.P (Author), Ewing, A. (Author), Gupta, A. (Author), Klamer, B. (Author), Mardis, E. (Author), Matsui, J. (Author), Olshefski, R.S (Author), Palmer, J.D (Author), Roberts, R.D (Author), Scharschmidt, T.J (Author), Setty, B.A (Author), Yeager, N.D (Author)
• Format: Article
• Language: English
• Published: NLM (Medline) 2022
• Subjects: adolescent; Adolescent; adverse event; child; Child; human; Humans; Kaplan Meier method; Kaplan-Meier Estimate; neoplasm; Neoplasms; Neoplasms, Second Primary; procedures; Progression-Free Survival; radiosurgery; Radiosurgery; Retrospective Studies; retrospective study; second cancer; treatment outcome; Treatment Outcome; young adult; Young Adult
• Online Access: View Fulltext in Publisher
• ISBN: 1748880X (ISSN)
• DOI: 10.1259/bjr.20211088

OBJECTIVE: The objective of this study is to report disease outcomes and toxicity with the use of stereotactic body radiation therapy (SBRT) in the treatment of pediatric metastatic disease. METHODS: All pediatric and adolescent young adult (AYA) patients' who received SBRT were included between the years 2000 and 2020. Study endpoints included local control (LC), progression-free survival (PFS), overall survival (OS), cumulative incidence (CI) of death or local failure and toxicity. The end points with respect to survival and LC were calculated using the Kaplan-Meier estimate. The cumulative incidence of local failure was calculated using death as a competing risk. RESULTS: 16 patients with 36 lesions irradiated met inclusion criteria and formed the study cohort. The median OS and PFS for the entire cohort were 17 months and 15.7 months, respectively. The 1 year OS for the entire cohort was 75%. The 6- and 12 month local control was 85 and 78%, respectively. There were no local failures in irradiated lesions for patients who received a BED10≥100 Gy. Patients who were treated with SBRT who had ≤5 metastatic lesions at first recurrence had a superior 1 year OS of 100 vs 50% for those with >5 lesions. One patient (6.3%) experienced a Grade 3 central nervous system toxicity. CONCLUSION: LC was excellent with SBRT delivered to metastatic disease, particularly for lesions receiving a BED10≥100 Gy. High-grade toxicity was rare in our patient population. Patients with five or fewer metastatic sites have a significantly better OS compared to >5 sites. ADVANCES IN KNOWLEDGE: This study demonstrates that SBRT is safe and efficacious in the treatment of pediatric oligometastatic disease.