Bölling T, Schuck A, Pape H, Rübe C, Meyer F-M, Martini C, Timmermann B, Asadpour B, Kortmann R-D, Beck J D, Langer T, Paulides M, Könemann S, Willich N
Klinik und Poliklinik für Strahlentherapie der Universitätsklinik Münster, Albert-Schweitzer-Strasse 33, 48129 Münster.
Klin Padiatr. 2007 May-Jun;219(3):139-45. doi: 10.1055/s-2007-973848.
Late effects after radiotherapy in childhood and adolescence have mainly been characterized retrospectively with small patient numbers. Therefore the German Group of Pediatric Radiation Oncology (APRO) established the "RegIster for the evaluation of late Side effects after radiation in childhood and adolescence" (RiSK). After a pilot phase starting in 2001 documentation has been performed all over Germany since 2004. This analysis shows the first results of "RiSK".
Radiation parameters including detailed organ doses as well as toxicity evaluations were collected prospectively from centers all over Germany in the study center. Standardized documentation forms were used. Documentation is planned for all children who receive radiotherapy in one of the German pediatric therapy trials.
Until December 31st 2006, 696 documentations of radiotherapy and 526 acute as well as 836 late follow-up documentation forms have been collected. Altogether, 41 patients with late grade 3 and 16 patients with late grade 4-side effects were identified. Side effects mainly concerned joints with functional impairment (after combined radiotherapy and surgery), the bowel, skin and subcutis as well as blood parameters under continued chemotherapy. Patients with late side effects of a higher grade were mainly treated for Ewing's or soft tissue sarcomas (n=235 patients), representing 33.8% of all patients in this study.
Fortunately, up to now only a few late grade 3 or 4 side effects of radiotherapy are shown for almost 700 documented patients. For further results, especially for the characterization of dose-effect-relationships, this study has to be continued with a higher patient number and a longer follow-up.
儿童和青少年放疗后的远期效应主要是通过回顾性研究、以少量患者为对象进行特征描述的。因此,德国儿科放射肿瘤学组(APRO)建立了“儿童和青少年放疗后远期副作用评估登记系统”(RiSK)。自2001年开始试点阶段后,自2004年起在德国全国范围内开展了记录工作。本分析展示了“RiSK”的首批结果。
前瞻性地从德国各地的中心收集放疗参数,包括详细的器官剂量以及毒性评估结果,并汇总至研究中心。使用标准化的记录表格。计划对所有参与德国儿科治疗试验且接受放疗的儿童进行记录。
截至2006年12月31日,已收集到696份放疗记录以及526份急性和836份远期随访记录表格。总共识别出41例3级远期副作用患者和16例4级远期副作用患者。副作用主要涉及功能受损的关节(放疗联合手术后)、肠道、皮肤和皮下组织,以及持续化疗情况下的血液参数。高等级远期副作用患者主要接受尤因肉瘤或软组织肉瘤治疗(n = 235例患者),占本研究所有患者的33.8%。
幸运的是,到目前为止,在近700例有记录的患者中,仅显示出少数放疗导致的3级或4级远期副作用。为获得更多结果,尤其是为了明确剂量 - 效应关系的特征,本研究必须纳入更多患者并进行更长时间的随访。