title: Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience).
abstract: OBJECTIVE
  To assess outcomes and prognostic factors in radiotherapy of pediatric central nervous system atypical teratoid/rhabdoid tumor (AT/RT).
  
  
  METHODS
  Seventeen patients with central nervous system AT/RT were retrospectively reviewed after curative radiotherapy as primary or adjuvant therapy between January 1990 and December 2003. Overall and failure-free survival rates were calculated using the Kaplan-Meier method. The log-rank method was used to compare the effects of dosage (>50 Gy or < or =50 Gy) and treatment duration (>45 days or < or =45 days). Multivariate analysis was performed for prognostic factors.
  
  
  RESULTS
  Median overall survival and failure-free survival were 17 and 11 months, respectively. The 3 longest-surviving patients were older, underwent gross tumor removal, and completed both craniospinal and focal boost irradiation. Multivariate analysis revealed a significant relationship between the following: overall survival and performance status (p = 0.019), failure-free survival and total irradiation dose (p = 0.037), time interval between surgery and radiotherapy initiation (p = 0.031), and time interval between surgery and radiotherapy end point (p = 0.047).
  
  
  CONCLUSIONS
  Radiotherapy is crucial in the treatment of AT/RT. We recommend initiating radiotherapy immediately postoperatively and before systemic chemotherapy in pediatric patients > or =3 years of age.
authors.affiliation: Cancer Center, Neurological Institute, Taipei, Taiwan.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Tai-Tong
authors.initials: TT
authors.lastname: Wong
authors.forename: Donald Ming-Tak
authors.initials: DM
authors.lastname: Ho
authors.forename: Pin-I
authors.initials: PI
authors.lastname: Huang
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Cheng-Ying
authors.initials: CY
authors.lastname: Shiau
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018335:Rhabdoid Tumor / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis; D013724:Teratoma / Q000532:radiotherapy* / Q000601:surgery