Zakem Sara J, Cost Carrye R, Cost Nicholas G, Robin Tyler P, Milgrom Sarah A
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
Department of Pediatric Hematology/Oncology/Bone Marrow Transplant, Children's Hospital Colorado, Aurora, Colorado.
Pediatr Blood Cancer. 2022 Mar;69(3):e29412. doi: 10.1002/pbc.29412. Epub 2021 Oct 26.
Brachytherapy (BT) delivers highly conformal radiation and spares surrounding tissues, which may limit late effects in pediatric, adolescent, and young adult (AYA) patients. We aimed to characterize trends in BT use for this population in the United States, focusing on patients with rhabdomyosarcoma (RMS).
The National Cancer Database was queried to identify patients ≤ 21 who were treated for solid tumor malignancies in the United States from 2004 to 2016. We obtained disease, treatment, and outcome data for patients treated with BT, in particular for RMS.
99 506 pediatric and AYA patients met study inclusion. Of these, 22 586 (23%) received radiation therapy (external beam radiation therapy [EBRT] and/or BT) and 240 (0.2%) received BT. Among patients treated with BT, 139 (58%) underwent surgery and 58 (24%) received EBRT. A total of 3836 patients were treated for RMS during this period. Of these, 2531 (66%) received any radiation and 37 (1%) received BT (EBRT + BT in 3, BT in 34). Of patients treated with BT for RMS, 28 (76%) underwent surgery + BT. Survival data were available for 31 patients treated with BT for RMS. With a median follow-up of 63 months, overall survival was 100% for patients with RMS of a favorable site treated with BT.
BT is rarely used to treat pediatric and AYA patients in the United States. Patients treated with BT for RMS experienced favorable survival, suggesting that this approach may not compromise oncologic outcomes and warrants further study as a therapeutic option in pediatric and AYA patients, specifically in RMS.
近距离放射治疗（BT）可提供高度适形的辐射并使周围组织免受辐射，这可能会减少儿科、青少年和年轻成人（AYA）患者的晚期效应。我们旨在描述美国该人群中BT使用的趋势，重点关注横纹肌肉瘤（RMS）患者。
查询国家癌症数据库，以识别2004年至2016年在美国接受实体瘤恶性肿瘤治疗的21岁及以下患者。我们获取了接受BT治疗患者的疾病、治疗和结局数据，特别是RMS患者的数据。
99506名儿科和AYA患者符合研究纳入标准。其中，22586名（23%）接受了放射治疗（外照射放疗[EBRT]和/或BT），240名（0.2%）接受了BT。在接受BT治疗的患者中，139名（58%）接受了手术，58名（24%）接受了EBRT。在此期间，共有3836名患者接受了RMS治疗。其中，2531名（66%）接受了任何形式的放疗，37名（1%）接受了BT（3名接受EBRT + BT，34名接受BT）。接受BT治疗的RMS患者中，28名（76%）接受了手术 + BT。有31名接受BT治疗的RMS患者的生存数据可用。中位随访63个月，接受BT治疗的预后良好部位的RMS患者的总生存率为100%。
在美国，BT很少用于治疗儿科和AYA患者。接受BT治疗的RMS患者生存情况良好，这表明这种方法可能不会影响肿瘤治疗效果，作为儿科和AYA患者（特别是RMS患者）的一种治疗选择值得进一步研究。
