Craniospinal irradiation and/or intraventricular radioimmunotherapy after high-dose chemotherapy and autologous stem cell rescue in patients with CNS retinoblastoma-Safety and outcomes.
CNS metastatic retinoblastoma
compartmental radioimmunotherapy
radiotherapy
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
31 Aug 2024
31 Aug 2024
Historique:
revised:
13
08
2024
received:
09
06
2024
accepted:
15
08
2024
medline:
1
9
2024
pubmed:
1
9
2024
entrez:
1
9
2024
Statut:
aheadofprint
Résumé
The prognosis for patients with central nervous system (CNS) retinoblastoma (RB) (trilateral or stage 4b metastatic RB) treated with high-dose chemotherapy and autologous stem cell transplant (HDC-ASCT) remains poor. The impact of irradiation when administered as part of upfront therapy post HDC-ASCT on treatment outcomes and survival is unknown. We performed a retrospective review of all patients with CNS RB (seven stage 4b, eight trilateral, one pineal lesion belonging to methylation group RB) who underwent induction chemotherapy with an intent to proceed to HDC-ASCT at two institutions. Twelve of 16 patients (n = 75%) achieved an objective response to induction chemotherapy, while four patients had progressive/refractory disease; two patients responded to subsequent therapy and proceeded to ASCT, and two patients did not. Seven of 14 patients who underwent HDC-ASCT, received radiotherapy as part of upfront therapy post HDC-ASCT in the form of craniospinal irradiation (CSI) (n = 3), intraventricular radioimmunotherapy (n = 3), or both CSI and intraventricular radioimmunotherapy (n = 1). The Kaplan-Meier estimate of overall survival for these patients was 62.5% at 5 years; no patients developed second malignant neoplasms within the radiation fields. For the seven patients who did not receive radiotherapy, the overall survival was 28.6% at 5 years. CSI (23.4 Gy) alone or in conjunction with intraventricular RIT may have clinical utility in eliminating persistent MRD post HDC-ASCT, contributing to improved disease-free survival in patients with CNS RB. This treatment strategy merits evaluation in a prospective, multicenter clinical trial for patients with CNS metastatic RB.
Sections du résumé
BACKGROUND
BACKGROUND
The prognosis for patients with central nervous system (CNS) retinoblastoma (RB) (trilateral or stage 4b metastatic RB) treated with high-dose chemotherapy and autologous stem cell transplant (HDC-ASCT) remains poor. The impact of irradiation when administered as part of upfront therapy post HDC-ASCT on treatment outcomes and survival is unknown.
METHODS
METHODS
We performed a retrospective review of all patients with CNS RB (seven stage 4b, eight trilateral, one pineal lesion belonging to methylation group RB) who underwent induction chemotherapy with an intent to proceed to HDC-ASCT at two institutions.
RESULTS
RESULTS
Twelve of 16 patients (n = 75%) achieved an objective response to induction chemotherapy, while four patients had progressive/refractory disease; two patients responded to subsequent therapy and proceeded to ASCT, and two patients did not. Seven of 14 patients who underwent HDC-ASCT, received radiotherapy as part of upfront therapy post HDC-ASCT in the form of craniospinal irradiation (CSI) (n = 3), intraventricular radioimmunotherapy (n = 3), or both CSI and intraventricular radioimmunotherapy (n = 1). The Kaplan-Meier estimate of overall survival for these patients was 62.5% at 5 years; no patients developed second malignant neoplasms within the radiation fields. For the seven patients who did not receive radiotherapy, the overall survival was 28.6% at 5 years.
CONCLUSIONS
CONCLUSIONS
CSI (23.4 Gy) alone or in conjunction with intraventricular RIT may have clinical utility in eliminating persistent MRD post HDC-ASCT, contributing to improved disease-free survival in patients with CNS RB. This treatment strategy merits evaluation in a prospective, multicenter clinical trial for patients with CNS metastatic RB.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e31297Subventions
Organisme : NCI Cancer Center Support
ID : P30CA008748
Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
Chantada G, Doz F, Antoneli CB, et al. A proposal for an international retinoblastoma staging system. Pediatr Blood Cancer. 2006;47(6):801‐805.
de Jong MC, Kors WA, de Graaf P, Castelijns JA, Kivela T, Moll AC. Trilateral retinoblastoma: a systematic review and meta‐analysis. Lancet Oncol. 2014;15(10):1157‐1167.
Yamanaka R, Hayano A, Takashima Y. Trilateral retinoblastoma: a systematic review of 211 cases. Neurosurg Rev. 2019;42(1):39‐48.
Blach LE, McCormick B, Abramson DH, Ellsworth RM. Trilateral retinoblastoma—incidence and outcome: a decade of experience. Int J Radiat Oncol Biol Phys. 1994;29(4):729‐733.
Paulino AC. Trilateral retinoblastoma: is the location of the intracranial tumor important? Cancer. 1999;86(1):135‐141.
Liu APY, Gudenas B, Lin T, et al. Risk‐adapted therapy and biological heterogeneity in pineoblastoma: integrated clinico‐pathological analysis from the prospective, multi‐center SJMB03 and SJYC07 trials. Acta Neuropathol. 2020;139(2):259‐271.
Namouni F, Doz F, Tanguy ML, et al. High‐dose chemotherapy with carboplatin, etoposide and cyclophosphamide followed by a haematopoietic stem cell rescue in patients with high‐risk retinoblastoma: a SFOP and SFGM study. Eur J Cancer. 1997;33(14):2368‐2375.
Jubran RF, Erdreich‐Epstein A, Butturini A, Murphree AL, Villablanca JG. Approaches to treatment for extraocular retinoblastoma: Children's Hospital Los Angeles experience. J Pediatr Hematol Oncol. 2004;26(1):31‐34.
Wright KD, Qaddoumi I, Patay Z, Gajjar A, Wilson MW, Rodriguez‐Galindo C. Successful treatment of early detected trilateral retinoblastoma using standard infant brain tumor therapy. Pediatr Blood Cancer. 2010;55(3):570‐572.
Dunkel IJ, Jubran RF, Gururangan S, et al. Trilateral retinoblastoma: potentially curable with intensive chemotherapy. Pediatr Blood Cancer. 2010;54(3):384‐387.
Farouk Sait S, Haque S, Karimi S, et al. A potential role for apparent diffusion coefficient in the diagnosis of trilateral retinoblastoma. J Pediatr Hematol Oncol. 2020;42(3):238‐243.
Dimaras H, Heon E, Doyle J, et al. Multifaceted chemotherapy for trilateral retinoblastoma. Arch Ophthalmol. 2011;129(3):362‐365.
Dunkel IJ, Chan HS, Jubran R, et al. High‐dose chemotherapy with autologous hematopoietic stem cell rescue for stage 4B retinoblastoma. Pediatr Blood Cancer. 2010;55(1):149‐152.
Dunkel IJ, Piao J, Chantada GL, et al. Intensive multimodality therapy for extraocular retinoblastoma: a Children's Oncology Group trial (ARET0321). J Clin Oncol. 2022;40(33):3839‐3847.
Abdelbaki MS, Abu‐Arja MH, Davidson TB, et al. Pineoblastoma in children less than six years of age: the Head Start I, II, and III experience. Pediatr Blood Cancer. 2020;67(6):e28252.
Kushner BH, Cheung NK, Kramer K, Dunkel IJ, Calleja E, Boulad F. Topotecan combined with myeloablative doses of thiotepa and carboplatin for neuroblastoma, brain tumors, and other poor‐risk solid tumors in children and young adults. Bone Marrow Transplant. 2001;28(6):551‐556.
Chang JW, Yu YS, Kim JY, et al. The clinical outcomes of proton beam radiation therapy for retinoblastomas that were resistant to chemotherapy and focal treatment. Korean J Ophthalmol. 2011;25(6):387‐393.
Biewald E, Kiefer T, Geismar D, et al. Feasibility of proton beam therapy as a rescue therapy in heavily pre‐treated retinoblastoma eyes. Cancers (Basel). 2021;13(8):1862.
Kramer K, Pandit‐Taskar N, Humm JL, et al. A phase II study of radioimmunotherapy with intraventricular 131I‐3F8 for medulloblastoma. Pediatr Blood Cancer. 2018;65(1):e26754.
Tringale KR, Wolden SL, Karajannis M, et al. Outcomes of intraventricular 131‐I‐omburtamab and external beam radiotherapy in patients with recurrent medulloblastoma and ependymoma. J Neurooncol. 2023;162(1):69‐78.
Luo LY, Kramer K, Cheung NV, et al. Reduced‐dose craniospinal irradiation for central nervous system relapsed neuroblastoma. Pediatr Blood Cancer. 2020;67(9):e28364.