دورية أكاديمية
Craniospinal irradiation for CNS leukemia: rates of response and durability of CNS control.
| العنوان: | Craniospinal irradiation for CNS leukemia: rates of response and durability of CNS control. |
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| المؤلفون: | Ebadi M; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Morse M; University of Washington School of Medicine, Seattle, WA, USA., Gooley T; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Ermoian R; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Halasz LM; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Lo SS; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Yang JT; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Blau MH; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA., Percival ME; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA, USA., Cassaday RD; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA, USA., Graber J; Department of Neurology, Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, USA., Taylor LP; Department of Neurology, Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, USA., Venur V; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA, USA., Tseng YD; Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, 98195, Seattle, WA, USA. Ydt2@uw.edu.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA. Ydt2@uw.edu. |
| المصدر: | Journal of neuro-oncology [J Neurooncol] 2024 Jan; Vol. 166 (2), pp. 351-357. Date of Electronic Publication: 2024 Jan 20. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 8309335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7373 (Electronic) Linking ISSN: 0167594X NLM ISO Abbreviation: J Neurooncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York : Springer Original Publication: Boston : M. Nijhoff, 1983- |
| مواضيع طبية MeSH: | Brain Neoplasms*/therapy , Craniospinal Irradiation*/adverse effects , Hematopoietic Stem Cell Transplantation* , Central Nervous System Neoplasms*/radiotherapy , Central Nervous System Neoplasms*/etiology , Leukemia, Myeloid, Acute*, Young Adult ; Humans ; Male ; Female ; Retrospective Studies ; Recurrence ; Cranial Irradiation |
| مستخلص: | Purpose: Management of CNS involvement in leukemia may include craniospinal irradiation (CSI), though data on CSI efficacy are limited. Methods: We retrospectively reviewed leukemia patients who underwent CSI at our institution between 2009 and 2021 for CNS involvement. CNS local recurrence (CNS-LR), any recurrence, progression-free survival (PFS), CNS PFS, and overall survival (OS) were estimated. Results: Of thirty-nine eligible patients treated with CSI, most were male (59%) and treated as young adults (median 31 years). The median dose was 18 Gy to the brain and 12 Gy to the spine. Twenty-five (64%) patients received CSI immediately prior to allogeneic hematopoietic cell transplant, of which 21 (84%) underwent total body irradiation conditioning (median 12 Gy). Among 15 patients with CSF-positive disease immediately prior to CSI, all 14 assessed patients had pathologic clearance of blasts (CNS-response rate 100%) at a median of 23 days from CSI start. With a median follow-up of 48 months among survivors, 2-year PFS and OS were 32% (95% CI 18-48%) and 43% (95% CI 27-58%), respectively. Only 5 CNS relapses were noted (2-year CNS-LR 14% (95% CI 5-28%)), which occurred either concurrently or after a systemic relapse. Only systemic relapse after CSI was associated with higher risk of CNS-LR on univariate analysis. No grade 3 or higher acute toxicity was seen during CSI. Conclusion: CSI is a well-tolerated and effective treatment option for patients with CNS leukemia. Control of systemic disease after CSI may be important for CNS local control. CNS recurrence may reflect reseeding from the systemic space. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: CNS; Craniospinal irradiation; Leukemia; Protons; Toxicity |
| تواريخ الأحداث: | Date Created: 20240120 Date Completed: 20240205 Latest Revision: 20240205 |
| رمز التحديث: | 20240205 |
| DOI: | 10.1007/s11060-023-04501-5 |
| PMID: | 38244173 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1573-7373 |
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| DOI: | 10.1007/s11060-023-04501-5 |