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Now exclusively online, access the latest SROA Radiation Oncology News for Administrators publication by clicking on this link.
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Children Fare Better in Trials When Radiation Oncologist Follows Protocol
May 16, 2011
More than half of the children with rhabdomyosarcoma and residual disease who participated in a recent clinical trial but did not receive the full radiation therapy protocol treatment experienced a recurrence, reported Lynn Million, M.D., and colleagues in the June 1, 2011, Red Journal.
The researchers reviewed the bed recurrences among 695 pediatric patients in the Intergroup Rhabdomyosarcoma Study Group to determine any correlation between protocol deviations and recurrences among the participants. They defined a major deviation as greater than 10 percent of the prescribed dose of 40 to 60 Gy, and minor deviations in dosing as 6 to 10 percent of the prescribed dose. The volume deviations was defined as the tumor being excluded from the postoperative tumor volume field or the treatment volume not being covered by the specified margin of 2 to 5 cm.
Of the 83 patients with operative bed recurrences, 46 (55 percent) did not receive the intended radiation therapy, with 39 major and seven minor deviations. The most frequent protocol deviation was radiation therapy omission, which accounted for 19 out of 46 recurrences, followed by the dose, volume and dose and volume deviation . A total of 63, or 76 percent of the children with recurrence died of the disease, despite retrieval therapy. This number included 13 of 19 children who did not receive radiation therapy.
“Over half of the operative bed recurrences were associated with noncompliance, with omission of radiation therapy the most common protocol deviation,” the authors concluded. “Three-fourths of children die when local-regional disease is not controlled, which emphasizes the importance of radiation therapy in the group II with rhabdomyosarcoma.”
This study can be accessed at http://www.redjournal.org/article/S0360-3016%2810%2900232-4/abstract.
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