Keshwani, K;
Boterberg, T;
Dieckmann, K;
Janssens, GO;
Laprie, A;
Timmermann, B;
Gaze, MN;
(2023)
Radical skeletal metastatic site irradiation in highrisk neuroblastoma: systematic review and proposal for a randomised trial: a report from the SIOPEN Radiotherapy Committee.
Journal of Cancer Metastasis and Treatment
, 9
(1)
10.20517/2394-4722.2022.32.
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Abstract
Aim: Neuroblastoma has a variable outcome depending on age, stage, and molecular pathology. Distant metastatic disease is the central feature of high-risk disease. Recommendations for irradiating persistent metastatic deposits with curative intent after systemic therapy vary. It is unclear to what extent this practice may improve local control or survival. This study systematically reviewed the evidence for skeletal metastatic site irradiation and made evidence-based recommendations for clinical practice. Methods: We systematically reviewed the literature on radical radiotherapy of persistent metastases after chemotherapy. The aim was to determine whether a position could be taken regarding metastatic site irradiation in combined modality treatment protocols aiming for a cure and whether recommendations could be formulated Results: The initial search yielded 445 results. After the title and abstract review, 13 full papers were retrieved. Ten papers were found suitable for data extraction. One additional paper was identified. All 11 were graded as Centre for Evidence-Based Medicine Step 4 in quality; there was no high-level evidence. There are suggestions of benefit for skeletal site irradiation in high-risk neuroblastoma; however, there is no certainty, and it was not possible to recommend a particular treatment policy. Conclusion: We recommend that consideration is given to a randomised evaluation of the benefits of radiotherapy to a limited number of residual post-induction-chemotherapy metastatic sites in good responders. This practice could be incorporated as an amendment to existing trials.
| Type: | Article |
|---|---|
| Title: | Radical skeletal metastatic site irradiation in highrisk neuroblastoma: systematic review and proposal for a randomised trial: a report from the SIOPEN Radiotherapy Committee |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.20517/2394-4722.2022.32 |
| Publisher version: | https://doi.org/10.20517/2394-4722.2022.32 |
| Language: | English |
| Additional information: | © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | Curative intent, high-risk neuroblastoma, skeletal metastases, radical radiotherapy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10182203 |
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