ArticlePediatric blood & cancer2023
Palliative radiotherapy for children: Symptom response and treatment-associated toxicity according to radiation therapy dose and fractionation.
Article in Pediatric blood & cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Gender role in radiotherapy: psychosocial differences between males and females during cancer care : Single-centre report on adult and paediatric oncological patients.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Gamma knife radiosurgery in pediatric neuro-oncology: histology-specific outcomes and age-adapted procedural strategies.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Hypofractionated Palliative Radiotherapy for Relapsed and Refractory High-Risk Neuroblastoma.Current oncology (Toronto, Ont.) · 2025Article
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6 authors.
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Abstract
BACKGROUND/
objectivesRadiotherapy is an effective palliative treatment in advanced cancer. Shorter palliative treatment courses are recommended for adults, though pediatric data addressing treatment efficacy and toxicity according to radiation therapy (RT) dose and fractionation are limited. DESIGN/
methodsTotal 213 patients aged 21 years or younger receiving 422 palliative radiotherapy treatment courses from 2003 to 2016 were included. Symptom response and treatment-associated toxicity were recorded and analyzed in relationship to demographic and treatment variables.
resultsCommon diagnoses included sarcoma (32.5%), neuroblastoma (24.9%), leukemia/lymphoma (14.9%), and central nervous system tumors (10.9%). The most common indication for treatment was pain (46.7%). Patients received a median of 10 fractions, 2.5 Gy dose per fraction, and 21 Gy total dose. Number of RT fractions was five or less in 166 (39.3%), six to 10 fractions in 117 (27.2%), and 10 or more fractions in 139 (32.9%) of courses. Complete or partial pain relief was achieved in 85% (151 of 178 evaluable patients), including 77.8% receiving five or less fractions and 89.6% receiving more than five fractions. Highest toxicity was grade 1 in 159 (38.9%), grade 2 in 26 (6.4%), and grade 3 in two (0.5%) treatments. On multivariable analysis, RT delivered 30 or more days from death (OR 12.13, 95% CI: 2.13-69.2, p = .005) and no adjuvant chemotherapy (OR 0.14, 95% CI: 0.03-0.54, p = .005) were significantly associated with pain response, and five or less fractions were significantly associated with lower toxicity (OR 0.24, 95% CI: 0.06-0.97, p = .045).
conclusionsPalliative RT courses of five or less fractions result in high rates of pain control and are associated with low toxicity in pediatric patients with cancer.
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