Late effects of radiotherapy for pediatric extremity sarcomas

Paulino, Arnold dela Cruz

doi:10.1016/j.ijrobp.2004.02.001

Cited by 171 publications

(115 citation statements)

References 17 publications

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“…Chronic complications include fibrosis, edema, soft-tissue necrosis (4,5), muscle atrophy, joint stiffness and contractures related to progressive fibrosis (3). The tumorigenic effect of radiation therapy has also been documented (13)(14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Side Effects of Radiation in Musculoskeletal Oncology: Clinical Evaluation of Radiation-Induced Fractures

Mavrogenis

Pala

Romantini

et al. 2011

Int J Immunopathol Pharmacol

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Radiation therapy and chemotherapy, while they remain an essential part of the multidisciplinary treatment of cancers, they have led to unwanted complications. Radiation-induced complications include wound and bone, growth, nervous system, tumorigenic, lung, gastrointestinal, hepatic and other complications. In this article we review the side effects of radiation therapy in musculoskeletal oncology emphasizing on bone, present our long experience, and discuss the current literature regarding radiation-induced bone complications and their management and outcome.

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Section: Discussionmentioning

confidence: 99%

Side Effects of Radiation in Musculoskeletal Oncology: Clinical Evaluation of Radiation-Induced Fractures

Mavrogenis

Pala

Romantini

et al. 2011

Int J Immunopathol Pharmacol

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“…Unfortunately, as with most treatments, ionizing radiation also produces dose-related side effects to surrounding normal tissue. Radiation therapy can be associated with complications, such as bone growth abnormalities, peripheral nerve injury, impaired mobility, and secondary malignancies (5). The frequency of significant late effects of radiotherapy can be as high as 80% (5).…”

Section: Introductionmentioning

confidence: 99%

“…Radiation therapy can be associated with complications, such as bone growth abnormalities, peripheral nerve injury, impaired mobility, and secondary malignancies (5). The frequency of significant late effects of radiotherapy can be as high as 80% (5). Adjuvant agents that augment the response of tumors to radiation might allow for the use of lower doses of ionizing radiation, thereby maintaining efficacy while decreasing toxicity.…”

Section: Introductionmentioning

confidence: 99%

IFN-β Restricts Tumor Growth and Sensitizes Alveolar Rhabdomyosarcoma to Ionizing Radiation

Sims

McGee

Williams

et al. 2010

Molecular Cancer Therapeutics

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Ionizing radiation is an important component of multimodal therapy for alveolar rhabdomyosarcoma (ARMS). We sought to evaluate the ability of IFN-β to enhance the activity of ionizing radiation.Rh-30 and Rh-41 ARMS cells were treated with IFN-β and ionizing radiation to assess synergistic effects in vitro and as orthotopic xenografts in CB17 severe combined immunodeficient mice. In addition to effects on tumor cell proliferation and xenograft growth, changes in the tumor microenvironment including interstitial fluid pressure, perfusion, oxygenation, and cellular histology were assessed.A nonlinear regression model and isobologram analysis indicated that IFN-β and ionizing radiation affected antitumor synergy in vitro in the Rh-30 cell line; the activity was additive in the Rh-41 cell line. In vivo continuous delivery of IFN-β affected normalization of the dysfunctional tumor vasculature of both Rh-30 and Rh-41 ARMS xenografts, decreasing tumor interstitial fluid pressure, increasing tumor perfusion (as assessed by contrast-enhanced ultrasonography), and increasing oxygenation. Tumors treated with both IFN-β and radiation were smaller than control tumors and those treated with radiation or IFN-β alone. Additionally, treatment with high-dose IFN-β followed by radiation significantly reduced tumor size compared with radiation treatment followed by IFN-β.The combination of IFN-β and ionizing radiation showed synergy against ARMS by sensitizing tumor cells to the cytotoxic effects of ionizing radiation and by altering tumor vasculature, thereby improving oxygenation. Therefore, IFN-β and ionizing radiation may be an effective combination for treatment of ARMS.Mol Cancer Ther; 9(3); 761-71. ©2010 AACR.

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“…However, in the growing child, potential growth retardation and deformity associated with the use of EBRT are a serious concern that can limit its use (1).…”

Section: Introductionmentioning

confidence: 99%

Feasibility report of conservative surgery, perioperative high-dose-rate brachytherapy (PHDRB), and low-to-moderate dose external beam radiation therapy (EBRT) in pediatric sarcomas

et al. 2004

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Purpose: This study was undertaken to determine the feasibility of perioperative highdose-rate brachytherapy (PHDRB) as an accelerated boost in patients with pediatric sarcomas. Methods and materials:Five pediatric patients (ages 7-16) with soft tissue sarcomas (STS) or soft tissue recurrences of previously treated osteosarcomas were treated with surgical resection and PHDRB (16-24 Gy) for R0-R1 resections. Patients with STS and osteosarcomas received 27 Gy and 45 Gy of EBRT postoperatively.Results: After a median follow-up of 27 months (range, 12-50) all the patients remain locally controlled. Only 1 patient developed regrowth of pulmonary metastases and died of distant disease at 16 months. Conclusions:The use of PHDRB is safe in the short-term in this pediatric population. Only 1 patient suffered a partial wound dehiscence that may not be entirely related to PHDRB. Patients withrecurrent osteosarcomas canbe treatedinafashion similartotheir adultsoft tissuecounterpartsand avoid limb amputation. Younger patients with STS may achieve local control and prevent growth retardation with a combination of PHDRB and moderate doses of EBRT.

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Late effects of radiotherapy for pediatric extremity sarcomas

Cited by 171 publications

References 17 publications

Side Effects of Radiation in Musculoskeletal Oncology: Clinical Evaluation of Radiation-Induced Fractures

Side Effects of Radiation in Musculoskeletal Oncology: Clinical Evaluation of Radiation-Induced Fractures

IFN-β Restricts Tumor Growth and Sensitizes Alveolar Rhabdomyosarcoma to Ionizing Radiation

Feasibility report of conservative surgery, perioperative high-dose-rate brachytherapy (PHDRB), and low-to-moderate dose external beam radiation therapy (EBRT) in pediatric sarcomas

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