Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience).
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.
Chen
Yi-Wei
YW
Cancer Center, Neurological Institute, Taipei, Taiwan.
Wong
Tai-Tong
TT
Ho
Donald Ming-Tak
DM
Huang
Pin-I
PI
Chang
Kai-Ping
KP
Shiau
Cheng-Ying
CY
Yen
Sang-Hue
SH
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