Radiotherapy for metastases to the mandible in children.
OBJECTIVE
We present a retrospective review of all children treated since 1979 at our institution with radiotherapy for symptomatic metastases that involve the mandible.


METHODS
Nine children were treated with 1 or more courses of radiotherapy for symptomatic metastases that involve the mandible. Six children had a neuroblastoma, 1 had angiosarcoma of the liver, 1 had adenocarcinoma of the rectum, and 1 had peripheral primitive neuroectodermal tumor (Ewing's sarcoma) of the spine. In 3 children, the mandible was the first bone involved by metastases. Seven children were treated with short intensive courses of radiotherapy consisting of 1 to 3 fractions to a total dose of 400 to 1,200 cGy. One child received 2,400 cGy in 6 fractions, and another child received 3,000 cGy in 10 fractions. Three children were treated with second courses of radiotherapy at 1, 2, and 5 months, respectively, from the initial course of radiotherapy. All children had received chemotherapy.


RESULTS
All children died of disseminated disease at 5 to 59 months from their initial diagnosis, 5 to 29 months from the detection of metastases to bone, and only 6 days to 17 months (median, 2 months) from the first treatment of metastases to the mandible.


CONCLUSIONS
The outlook for children with metastases that involve the mandible is very poor, and we recommend short intensive courses of radiotherapy consisting of 1 to 3 treatments to total doses of 400 to 1,200 cGy for palliation of pain.
Deutsch
Melvin
M
Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. deutschm@msx.upmc.edu
Wollman
Michael R
MR
D000230:Adenocarcinoma / Q000532:radiotherapy / Q000556:secondary; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006394:Hemangiosarcoma / Q000532:radiotherapy / Q000556:secondary; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D008339:Mandibular Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D009447:Neuroblastoma / Q000532:radiotherapy / Q000556:secondary; D010148:Intractable Pain / Q000532:radiotherapy; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000532:radiotherapy / Q000556:secondary; D013125:Spinal Neoplasms / Q000473:pathology