RESUMO
BACKGROUND AND PURPOSE: The aim of our retrospective study was to analyze the clinical outcome of paediatric glioma patients treated with radiation therapy (RT) in our institution. MATERIAL AND METHODS: We retrieved the case records of all children with gliomas (age < 18 years) who received RT in our department between 2004 and 2007. We analyzed the information regarding patients' demography, clinical details, treatment given, RT details, and survival. The event-free survival (EFS), the period from the date of completion of RT to the date of the event, i.e. death/recurrence, was calculated with respect to age, sex, location of tumour (brainstem vs. non-brainstem), histopathology (low grade vs. high grade), extent of surgical resection, dose and duration of RT, and use of chemotherapy. RESULTS: A total of 70 children with glioma received RT during the above-mentioned period. The 3-year EFS rate for all patients was 44% and the median EFS period was 18 months. The 3-year EFS in patients who underwent surgical decompression and no surgery was 58% and 25%, respectively (p < 0.05). Patients with brainstem lesions had statistically significantly lower 3-year EFS to non-brainstem gliomas (28% vs. 56%, p < 0.01). Chemotherapy use showed no statistically significant trend towards better survival. CONCLUSIONS: RT is an effective modality of treatment in paediatric glioma patients in our setup. Early use of RT in incompletely resected low-grade gliomas is worth revisit-ing. Results of chemotherapy in high-grade glioma and brainstem gliomas are encouraging.
Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Glioma/patologia , Glioma/radioterapia , Adolescente , Neoplasias Encefálicas/cirurgia , Neoplasias do Tronco Encefálico/patologia , Neoplasias do Tronco Encefálico/radioterapia , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/radioterapia , Criança , Pré-Escolar , Terapia Combinada , Intervalo Livre de Doença , Feminino , Glioma/cirurgia , Humanos , Masculino , Estadiamento de Neoplasias , Polônia , Prognóstico , Dosagem Radioterapêutica , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of present study was to analyze the results of pulsed-dose-rate (PDR) brachytherapy in patients with cervical carcinoma treated at our center. METHODS: From September 2003 to September 2005, 48 patients with histopathologically proved cervical carcinoma, stages IB to IVA, were treated with PDR intracavitary radiotherapy (ICRT) and pelvic irradiation at our center. Radiotherapy consisted of whole pelvis external beam radiation therapy (EBRT) with a dose of 40 Gy in 22 fractions over 4.5 weeks followed by 10 Gy in 5 fractions over 1 week with midline shielding. Weekly chemotherapy (Cisplatin, 40 mg/m) was administered during the course of EBRT to suitable patients. After an interval of 1 to 2 weeks, a single session of standard ICRT application was done to deliver a dose of 27 Gy to point A by PDR (hourly pulse, 70 cGy). RESULTS: Median age was 50 years (range: 30-65). FIGO stage distribution of the patients was as follows: stage IB, 6; stage IIA, 1; stage IIB, 15; stage IIIB, 25; and stage IVA, 1. Follow-up period ranged from 3 to 50 months (median: 15 months). Ten patients had disease recurrence (5 each in stage IIB and stage IIIB). Eight patients had pelvic failure, 1 had bone metastases, and 1 had supraclavicular node metastases. Overall grades III to IV late toxicity rate at 50 months was 6%. For the median follow-up period of 15 months, the actuarial recurrence-free survival in stages I to II was 82% and stages III to IV was 78%. CONCLUSION: Our results reveal that PDR ICRT in combination with pelvic EBRT provides excellent pelvic disease control, survival, and low radiation related morbidity rate in the patients with cervical carcinoma.
