Palliative radiotherapy in pediatric malignancies

Abstract

9050 Background: To evaluate the role of palliative radiotherapy in the management of incurable pediatric malignancies. Methods: Records of 40 pediatric patients treated between Jan’ 2003 and Nov’ 2005 were reviewed and analyzed retrospectively. All of theses 40 children received palliative external beam radiotherapy for symptom control. Palliative radiotherapy was given either as single modality or in addition to surgery, chemotherapy and symptom relief drugs. Information recorded for each patient included age, sex, and extent of disease, histological types, symptomatology, treatment methods and symptom relief. Results: There were 28 boys and 12 girls in the age group of 1 to 18 years, with a median age of 14 years (range of 1–18 years). Predominant symptoms were swelling with or without pain, bleeding, and weakness of limbs. The median duration of symptoms was 90 days (range of 4–50 days). The diagnosis of these children varied with different histologies, most in the group of malignant round cell tumors (11), retinoblastoma (4), neuroblastoma (4), AML with chloromas (3), Ewing’s sarcoma (4). All patients presented with advanced stages of disease. Out of 40 patients 18 (45%) had disseminated disease at presentation. Nine patients underwent surgery while 32 patients received chemotherapy and all but two patients received symptom relief drugs in addition to palliative radiotherapy. The various dose schedules were either 5 Gy or 8 Gy for single fraction treatment while the dose schedules for fractionated radiotherapy ranged from 20 Gy in 5 fractions to 30 Gy in 10 fractions. Four patients showed complete resolution, 20 patients showed good, while 15 patients had little, 1did not have any relief in their symptoms. At the completion of multimodality treatment, 18 patients had partial response, 8 patients had progressive disease, 8 had stable disease and two patients had complete response. The disease status of 4 patients could not be known. Conclusions: The role of radiotherapy as palliative modality in children with locally advanced lesions provides better symptom relief in combination with other modalities of treatment. No significant financial relationships to disclose.