Hypofractionated re-irradiation to the brainstem in children with recurrent brain tumors.
To characterize radiation necrosis following hypofractionated brainstem re-irradiation in pediatric patients, we reviewed 23 cases with 28 tumors invading or abutting brainstem and treated with hypofractionated re-irradiation from 2004 to 2014. Re-irradiation delivered total doses of 16-30 Gy in two to five fractions. The most commons regimens used were 24 Gy in three fractions and 25 Gy in five fractions. At median follow-up of 12.8 months, median overall survival was 14.7 months and eight in-field recurrences were detected (median time 10.5 months). Five patients experienced symptomatic brainstem necrosis, and all having received 24 Gy in three fractions. Hypofractionated brainstem re-irradiation may be safer in five fractions.
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Timothy V
TV
Waxweiler
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Arya
A
Amini
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Yevgeniy
Y
Vinogradskiy
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Norman
N
Yeh
Division of Neuro-Oncology, Department of Pediatrics, The Children's Hospital Colorado, Aurora, Colorado.
Nicholas K
NK
Foreman
Department of Neurosurgery, The Children's Hospital Colorado, Aurora, Colorado.
Todd C
TC
Hankinson
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Arthur K
AK
Liu
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D000069473:Radiation Dose Hypofractionation; D000069475:Re-Irradiation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
CNS tumors; brain tumors; brainstem; radiation; re-irradiation