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Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents : Results From the IPPARCA Collaboration

Pixberg, Caroline; Koch, Raphael; Eich, Hans Theodor; Martinsson, Ulla; Kristensen, Ingrid; Matuschek, Christiane; Kortmann, Rolf-Dieter; Pohl, Fabian; Elsayad, Khaled and Christiansen, Hans, et al. (2016) In International Journal of Radiation Oncology, Biology, Physics 94(4). p.9-792
Abstract

PURPOSE: In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae.

MATERIALS AND METHODS: Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.

RESULTS: As of June... (More)

PURPOSE: In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae.

MATERIALS AND METHODS: Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.

RESULTS: As of June 2013, 1500 children have been recruited into the RiSK database and 485 into the RADTOX registry leading to an analysis population of 1359 patients (age range 0-18). A total of 18.9% (n=257) of all investigated patients developed high-grade acute toxicity (grades 3/4). High-grade toxicity of the bone marrow was documented for 63.8% (n=201) of those patients, oral mucositis for 7.6% (n=24), and dermatitis for 7.6% (n=24). Patients with high-grade acute toxicity received concomitant chemotherapy more frequently (56%) than patients with no or lower acute toxicity (31.5%). In multivariate analyses, concomitant chemotherapy, diagnosis of Ewing sarcoma, and total radiation dose showed a statistically noticeable effect (P≤.05) on acute toxicity, whereas age, concomitant chemotherapy, Hodgkin lymphoma, Ewing sarcoma, total radiation dose, and acute toxicity influenced the time until maximal late toxicity.

CONCLUSIONS: Generally, high-grade acute toxicity after irradiation in children and adolescence occurs in a moderate proportion of patients (18.9%). As anticipated, the probability of acute toxicity appeared to depend on the prescribed dose as well as concomitant chemotherapy. The occurrence of chronic toxicity correlates with the prior acute toxicity grade. Age seems to influence the time until maximal late toxicity but not the development of acute toxicity.

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International Journal of Radiation Oncology, Biology, Physics
volume
94
issue
4
pages
8 pages
publisher
Elsevier
external identifiers
  • Scopus:84959505563
ISSN
0360-3016
DOI
10.1016/j.ijrobp.2015.12.353
language
English
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no
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5ae84724-2d71-4ce3-a1d7-1a847383e560
date added to LUP
2016-04-11 14:48:20
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2016-10-26 08:37:36
@misc{5ae84724-2d71-4ce3-a1d7-1a847383e560,
  abstract     = {<p>PURPOSE: In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae.</p><p>MATERIALS AND METHODS: Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.</p><p>RESULTS: As of June 2013, 1500 children have been recruited into the RiSK database and 485 into the RADTOX registry leading to an analysis population of 1359 patients (age range 0-18). A total of 18.9% (n=257) of all investigated patients developed high-grade acute toxicity (grades 3/4). High-grade toxicity of the bone marrow was documented for 63.8% (n=201) of those patients, oral mucositis for 7.6% (n=24), and dermatitis for 7.6% (n=24). Patients with high-grade acute toxicity received concomitant chemotherapy more frequently (56%) than patients with no or lower acute toxicity (31.5%). In multivariate analyses, concomitant chemotherapy, diagnosis of Ewing sarcoma, and total radiation dose showed a statistically noticeable effect (P≤.05) on acute toxicity, whereas age, concomitant chemotherapy, Hodgkin lymphoma, Ewing sarcoma, total radiation dose, and acute toxicity influenced the time until maximal late toxicity.</p><p>CONCLUSIONS: Generally, high-grade acute toxicity after irradiation in children and adolescence occurs in a moderate proportion of patients (18.9%). As anticipated, the probability of acute toxicity appeared to depend on the prescribed dose as well as concomitant chemotherapy. The occurrence of chronic toxicity correlates with the prior acute toxicity grade. Age seems to influence the time until maximal late toxicity but not the development of acute toxicity.</p>},
  author       = {Pixberg, Caroline and Koch, Raphael and Eich, Hans Theodor and Martinsson, Ulla and Kristensen, Ingrid and Matuschek, Christiane and Kortmann, Rolf-Dieter and Pohl, Fabian and Elsayad, Khaled and Christiansen, Hans and Willich, Normann and Lindh, Jack and Steinmann, Diana},
  issn         = {0360-3016},
  language     = {eng},
  month        = {03},
  number       = {4},
  pages        = {9--792},
  publisher    = {ARRAY(0x85eea60)},
  series       = {International Journal of Radiation Oncology, Biology, Physics},
  title        = {Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents : Results From the IPPARCA Collaboration},
  url          = {http://dx.doi.org/10.1016/j.ijrobp.2015.12.353},
  volume       = {94},
  year         = {2016},
}