SynthesisJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
Influence of Cranial Radiotherapy on Outcome in Children With Acute Lymphoblastic Leukemia Treated With Contemporary Therapy.
Registry-linked trialAbstract readMeta-Analysis
In one paragraph
Synthesis in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00137111 (Total XV - Total Therapy Study XV for Newly Diagnosed Patients With Acute Lymphoblastic Leukemia), which is not on this map. Cited by 57 papers.
0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Total XV - Total Therapy Study XV for Newly Diagnosed Patients With Acute Lymphoblastic Leukemia
Who cites it
57 citing papers in PubMed.
- Impact of central nervous system involvement in adult patients with Philadelphia-negative acute lymphoblastic leukemia: a GRAALL-2005 study.Haematologica · 2023Trial
- Trial
- Improved CNS Control of Childhood Acute Lymphoblastic Leukemia Without Cranial Irradiation: St Jude Total Therapy Study 16.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019Trial
- Phase II/III study in children and adolescents with newly diagnosed B-cell precursor acute lymphoblastic leukemia: protocol for a nationwide multicenter trial in Japan.Japanese journal of clinical oncology · 2018Trial
- Discrepancy between central nervous system involvement at diagnosis and relapse burden in childhood acute lymphoblastic leukemia: a five-year cohort study in a middle-income setting.Frontiers in oncology · 2026Article
- Flow cytometric analysis of cerebrospinal fluid identifies patients with occult central nervous system involvement in relapsed pediatric acute lymphoblastic leukemia.Haematologica · 2026Article
- Extracellular vesicles released by ALL patients contain HNE-adducted proteins: Implications of collateral damage.Free radical biology & medicine · 2025Article
- No clear benefit of preventive cranial radiotherapy in childhood Philadelphia-positive acute lymphoblastic leukemia: a retrospective analysis of the EsPhALL2010 study.Haematologica · 2024Article
- Article
- Diagnostic and treatment strategies for pediatric acute lymphoblastic leukemia in low- and middle-income countries.Leukemia · 2024Review
- Article
- Article
- Review
- Acute Lymphoblastic Leukemia with Central Nervous System Involvement-Challenges in Management.Indian journal of pediatrics · 2024Review
- Advancing Diagnostics and Therapy to Reach Universal Cure in Childhood ALL.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Review
- Cranial radiotherapy has minimal benefit in children with central nervous system involvement in T-ALL.Blood advances · 2023Article
- Review
- Childhood Acute Lymphoblastic Leukemia Showing Unilateral Motor Dysfunction Prior to Chemotherapy: A Diffusion Tensor Tractography Study.Children (Basel, Switzerland) · 2023Article
- Central Nervous System Prophylaxis and Treatment in Acute Leukemias.Current treatment options in oncology · 2022Review
- Central nervous system involvement in childhood acute lymphoblastic leukemia: challenges and solutions.Leukemia · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Ajay VoraAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan. ajay.vora@sch.nhs.uk.
Anita AndreanoAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Ching-Hon PuiAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Stephen P HungerAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Martin SchrappeAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Anja MoerickeAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Andrea BiondiAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Gabriele EscherichAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Lewis B SilvermanAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Nicholas GouldenAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Mervi TaskinenAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Rob PietersAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Keizo HoribeAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Meenakshi DevidasAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Franco LocatelliAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Maria Grazia ValsecchiAjay Vora, Sheffield Children's Hospital and University of Sheffield, Sheffield; Nicholas Goulden, Great Ormond Street Hospital, London, United Kingdom; Anita Andreano and Maria Grazia Valsecchi, School of Medicine and Surgery, University of Milano-Bicocca, Milan; Andrea Biondi, University of Milano-Bicocca, Monza; Franco Locatelli, Bambino Gesù Children's Hospital, Rome, and University of Pavia, Pavia, Italy; Ching-Hon Pui, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN; Stephen P. Hunger, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Lewis B. Silverman, Dana-Faber Cancer Institute and Boston Children's Hospital, Boston, MA; Meenakshi Devidas, Children's Oncology Group Statistics and Data Center and University of Florida, Gainesville, FL; Martin Schrappe and Anja Moericke, University Medical Centre and Christian-Albrechts-University, Kiel; Gabriele Escherich, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Mervi Taskinen, Helsinki University Hospital, Helsinki, Finland; Rob Pieters, Princess Máxima Center for Pediatric Oncology, Utrecht, and Dutch Childhood Oncology Group, the Hague, the Netherlands; and Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Funding
COG FOREIGN ACCRUALU10CA098543 · NCI · NATIONAL CHILDHOOD CANCER FOUNDATION · PI ADAMSON, PETER C. · 2003 to 2013
$335.5MViral Vector Technology (VVTSR)P30CA021765 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI CHARLES ROBERTS · 1985 to 2026
$166.9MCOG SDMC - Statistics CoreU10CA180899 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI TODD A ALONZO · 2014 to 2026
$132.8MChildren's Oncology Group Statistics &Data Center GrantU10CA098413 · NCI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI DEVIDAS, MEENAKSHI · 2003 to 2013
$67.5MUsing social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2MCPML - Project 3: Genome-wide Studies of Adverse EffectsP50GM115279 · NIGMS · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI LOH, MIGNON LEE-CHEUN, RELLING, MARY V · 2015 to 2019
$15.1MPHARMACOGENOMICS OF CHILDHOOD LEUKEMIA (ALL)R37CA036401 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI EVANS, WILLIAM E · 1987 to 2014
$9.7MPAARK4Kids-Pharmacogenomics of Anticancer Agents Research in ChildrenU01GM092666 · NIGMS · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI RELLING, MARY V · 2010 to 2014
$8.9MPharmacogenomics of Childhood Leukemia ALLR01CA036401 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI EVANS, WILLIAM E · 1985 to 2019
$3.6MNCATS NIH HHS UL1 TR001427NCI NIH HHS CA21765NCI NIH HHS CA36401NCI NIH HHS P30 CA021765NCI NIH HHS R01 CA036401NCI NIH HHS R37 CA036401NCI NIH HHS U10 CA098413NCI NIH HHS U10 CA098543NCI NIH HHS U10 CA180899NCI NIH HHS U10 CA98413NCI NIH HHS U10CA98543NIGMS NIH HHS P50 GM115279NIGMS NIH HHS U01 GM092666NIGMS NIH HHS U01 GM92666
Abstract
purposeWe sought to determine whether cranial radiotherapy (CRT) is necessary to prevent relapse in any subgroup of children with acute lymphoblastic leukemia (ALL). PATIENTS AND
methodsWe obtained aggregate data on relapse and survival outcomes for 16,623 patients age 1 to 18 years old with newly diagnosed ALL treated between 1996 and 2007 by 10 cooperative study groups from around the world. The proportion of patients eligible for prophylactic CRT varied from 0% to 33% by trial and was not related to the proportion eligible for allogeneic stem-cell transplantation in first complete remission. Using a random effects model, with CRT as a dichotomous covariate, we performed a single-arm meta-analysis to compare event-free survival and cumulative incidence of isolated or any CNS relapse and isolated bone marrow relapse in high-risk subgroups of patients who either did or did not receive CRT.
resultsAlthough there was significant heterogeneity in all outcome end points according to trial, CRT was associated with a reduced risk of relapse only in the small subgroup of patients with overt CNS disease at diagnosis, who had a significantly lower risk of isolated CNS relapse (4% with CRT v 17% without CRT; P = .02) and a trend toward lower risk of any CNS relapse (7% with CRT v 17% without CRT; P = .09). However, this group had a relatively high rate of events regardless of whether or not they received CRT (32% [95% CI, 26% to 39%] v 34% [95% CI, 19% to 54%]; P = .8).
conclusionCRT does not have an impact on the risk of relapse in children with ALL treated on contemporary protocols.
Indexed as
AdolescentAntimetabolites, AntineoplasticChildChild, PreschoolCranial IrradiationHumansInfantLinear ModelsMethotrexatePrecursor Cell Lymphoblastic Leukemia-LymphomaRandomized Controlled Trials as TopicRetrospective StudiesSecondary PreventionTreatment OutcomeAntimetabolites, AntineoplasticMethotrexate
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NCT00137111ClinicalTrials.gov
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