Neuroendocrine late effects after tailored photon radiotherapy for children with low grade gliomas: Long term correlation with tumour and treatment parameters

Radiother Oncol. 2017 Nov;125(2):241-247. doi: 10.1016/j.radonc.2017.09.034. Epub 2017 Oct 13.

Abstract

Purpose: To evaluate neuroendocrine late effects in paediatric patients with low grade glioma (LGG) who underwent radiotherapy.

Methods and material: We performed a retrospective evaluation of 40 children with LGG treated from July 2002 to January 2015 with external radiotherapy. Tumour locations were cerebral hemisphere (n=2); posterior fossa (n=15); hypothalamic-pituitary axis (HPA, n=15); spine (n=5). Three patients presented a diffuse disease. We looked for a correlation between endocrine toxicity and tumour and treatment parameters. The impact of some clinical and demographic factors on endocrinal and neuro toxicity was evaluated using the log-rank test.

Results: The median follow-up was 52months (range: 2-151). Median age at irradiation was 6. The dose to the HPA was significantly associated with endocrine toxicity (P value=0.0190). Patients who received chemotherapy before radiotherapy and younger patients, showed worse performance status and lower IQ. The 5-year overall survival (OS) and progression free survival (PFS) rates were 94% and 73.7%, respectively.

Conclusion: Radiotherapy showed excellent OS and PFS rates and acceptable late neuroendocrine toxicity profile in this population of LGG patients treated over a period of 13years. In our experience, the dose to the HPA was predictive of the risk of late endocrine toxicity.

Keywords: Low grade gliomas; Neuroendocrine late toxicity; Paediatric tumours; Radiotherapy.

MeSH terms

  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy*
  • Child
  • Child, Preschool
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Glioma / pathology
  • Glioma / radiotherapy*
  • Humans
  • Male
  • Neoplasm Grading
  • Neurosecretory Systems / radiation effects*
  • Photons / adverse effects*
  • Photons / therapeutic use*
  • Radiation Injuries / etiology*
  • Retrospective Studies