Excellent therapeutic efficacy and minimal late neurotoxicity in children treated with 18 grays of cranial radiation therapy for high-risk acute lymphoblastic leukemia : A 7-year follow-up study of the dana-farber cancer institute consortium protocol 87-01
✍ Scribed by Deborah P. Waber; Brenda L. Shapiro; Sarah C. Carpentieri; Richard D. Gelber; Guangyong Zou; Annie Dufresne; Ivonne Romero; Nancy J. Tarbell; Lewis B. Silverman; Stephen E. Sallan
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 89 KB
- Volume
- 92
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Background:
In the current study, the authors evaluated late neuropsychologic effects 7 years after diagnosis and the long-term survival in a cohort of patients treated for high-risk childhood acute lymphoblastic leukemia (all) with cranial radiation therapy. efficacy and toxicity were evaluated in relation to patient age at diagnosis (age < or > or = 36 months).
Methods:
Two hundred and one patients treated for high-risk all on the dana-farber cancer institute consortium protocol 87-01 were included, 147 of whom were in continuous complete disease remission and were eligible for cognitive testing. sixty-one patients consented to undergo testing. all patients received 18 grays (gy) of cranial radiation as a component of central nervous system treatment.
Results:
For all 201 patients, the 5-year overall survival (% +/- the standard error) was 82% +/- 2 and the 5-year event-free survival (% +/- the standard error) was 75% +/- 3. only two patients developed a central nervous system recurrence. intelligence quotient (iq) and memory were at the expected mean for age, but performance on a complex figure drawing task was found to be reduced. children who were age < 36 months at the time of diagnosis were found to have an iq in the average range, but showed verbal deficits.
Conclusions:
The results of the current study demonstrate excellent efficacy of therapy and relatively limited late neurotoxicity on a childhood all therapy protocol in which all evaluated patients had received 18 gy of cranial radiation. efficacious therapy that includes cranial radiation does not appear to necessarily incur a heightened risk for significant cognitive impairment.