Newsletter - New books and Journal Articles of interest

New Books and Journal Articles of Interest to the Pediatric Radiation Oncologist

This section is managed by Professor Edward Halperin who will collect all information, comments on articles or thoughts you wish to send to him.

In this section you can talk about events which have made an impact on you, or which you feel it is important to share. These may concern scientific articles, congresses, thoughts on training for young people, the handling of tumours in children by health authorities.

It is also an opportunity to compare different practices throughout the world. Please send all ideas, suggestions and comments to Edward Halperin.

 

 September 2022 : 

 

Gallego Perez-Larraya J et al. Oncoloytic DNX-2401 virus for pediatric diffuse intrinsic pontine glioma. New Eng J Med 2022; 386-2471-2481.

Galanis E. Virotherapy for brain tumors - defining the path to success. New Eng J Med 2022; 386:2520-2522.

Children between 1 and 18 years of age with diffuse intrinsic pontine glioma (DIPG) were biopsied and treated, in a dose-escalation design study, with viral particles of DNX-2401 delivered by a catheter placed in the cerebellar peduncle. Eleven of the 12 patients subsequently received 39 to 59.4 Gy of external beam irradiation. Eight of the 12 children had a H3.3 K27M mutation, 8% each with a H3.1 K27M and H3.2 K27M mutation,  and 42% had a TP53 mutation.

Adverse events were headache, nausea, vomiting, and fatigue. Hemiparesis and tetraparesis developed in one patient each. Reduction in tumor cross-sectional areas were seen in 9 of 12 patients. Three patients (25%) had a reduction of at least 25% in the cross-sectional tumor area lasting at least 8 weeks. Median overall survival was 17.8 months with three patients alive at 19.6, 31.4, and 33.5 months.

There was evidence of biological activity from the viral infusion producing an immunostimlatory response. One cannot clearly distinguish the effect of oncolytic vial therapy versus radiotherapy since both were administered. 

Laskar S et al. Radiation therapy dose escalation in unresectable Ewing sarcoma: final results of a phase 3 randomized controlled trial Int J Rad Oncol Biol Phys 113:996-1002, 2022

95 patients with unresectable Ewing sarcoma were randomized between 55.8 Gy and 70.2 Gy whilst receiving vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Two-thirds of the tumors were pelvic and the median tumor size maximum dimension was 9.75 cm. 

At a median follow-up of 67 months the five-year local control for the 70.2 Gy arm was 76.4% v. 49.4% for 55.8 Gy (p=0.02); five-year disease-free survival was 46.7% v. 31.8% (p-0.22), and overall survival was 58.8% v. 45.4% (p=0.08). RTOG >2 acute skin toxicity was 10.4% v. 2.1% (p=0.08).

Edward C. Halperin MD MA

 

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