Browsing by Author "Seravalli, Enrica"

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    Radical radiotherapy for paediatric solid tumour metastases: An overview of current European protocols and outcomes of a SIOPE multicenter survey
    (Elsevier, 2021-01-16) Huijskens, Sophie C.; Kroon, Petra S.; Gaze, Mark N.; Gandola, Lorenza; Bolle, Stephanie; Supiot, Stephane; Abakay, Candan D.; Alexopoulou, Aikaterini; Bokun, Jelena; Chojnacka, Marzanna; Escande, Alexandre; Giralt, Jordi; Harrabi, Semi; Maduro, John H.; Mandeville, Henry; Mussano, Anna; Napieralska, Aleksandra; Padovani, Laetitia; Scarzello, Giovanni; Timmermann, Beate; Claude, Line; Seravalli, Enrica; Janssens, Geert O.; DEMİRÖZ ABAKAY, CANDAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; 0000-0001-5380-5898 ; AAH-3855-2021
    Purpose/objective: About 20% of children with solid tumours (ST) present with distant metastases (DM). Evidence regarding the use of radical radiotherapy of these DM is sparse and open for personal interpretation. The aim of this survey was to review European protocols and to map current practice regarding the irradiation of DM across SIOPE-affiliated countries.Materials/methods: Radiotherapy guidelines for metastatic sites (bone, brain, distant lymph nodes, lung and liver) in eight European protocols for rhabdomyosarcoma, non-rhabdomyosarcoma soft-tissue sarcoma, Ewing sarcoma, neuroblastoma and renal tumours were reviewed. SIOPE centres irradiating >= 50 children annually were invited to participate in an online survey.Results: Radiotherapy to at least one metastatic site was recommended in all protocols, except for high-risk neuroblastoma. Per protocol, dose prescription varied per site, and information on delineation and treatment planning/delivery was generally missing.Between July and September 2019, 20/27 centres completed the survey. Around 14% of patients were deemed to have DM from ST at diagnosis, of which half were treated with curative intent. A clear cut-off for a maximum number of DM was not used in half of the centres. Regardless of the tumour type and site, conventional radiotherapy regimens were most commonly used to treat DM. When stereotactic radiotherapy was used, a wide range of fractionation regimens were applied.Conclusion: Current radiotherapy guidelines for DM do not allow a consistent approach in a multicentre setting. Prospective (randomised) trials are needed to define the role of radical irradiation of DM from paediatric ST.
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    Towards homogenization of total body irradiation practices in pediatric patients across SIOPE affiliated centers. A survey by the SIOPE radiation oncology working group
    (Elsevier Ireland Ltd, 2021-02-01) Hoeben, Bianca A. W.; Pazos, Montserrat; Albert, Michael H.; Seravalli, Enrica; Bosman, Mirjam E.; Losert, Christoph; Boterberg, Tom; Manapov, Farkhad; Ospovat, Inna; Milla, Soraya Mico; Abakay, Candan Demiröz; Engellau, Jacob; Kos, Gregor; Supiot, Stephane; Bierings, Marc; Janssens, Geert O.; DEMİRÖZ ABAKAY, CANDAN; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; 0000-0001-5380-5898 ; AAH-3855-2021
    Background and purpose: To reduce relapse risk, Total Body Irradiation (TBI) is part of conditioning regimens for hematopoietic stem cell transplantation (HSCT) in pediatric acute leukemia. The study purpose was to evaluate clinical practices regarding TBI, such as fractionation, organ shielding and delivery techniques, among SIOPE affiliated radiotherapy centers.Methods: An electronic survey was sent out to 233 SIOPE affiliated centers, containing 57 questions about clinical practice of TBI. Surveys could be answered anonymously.Results: From over 25 countries, 82 responses were collected. For TBI-performing centers, 40/48 irradiated <= 10 pediatric patients annually (range: 1-2 to >25). Most indications concerned acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Four different fractionation schedules were used, of which 12 Gy in 6 fractions was applied in 91% for ALL and 86% for AML. Dose reduction to the lungs, mostly to a mean dose of 8-10 Gy, was applied by 28/33 centers for ALL and 19/21 centers for AML, in contrast to much less applied dose reduction to the kidneys (7/33 ALL and 7/21 AML), thyroid (2/33 ALL and 2/21 AML), liver (4/33 ALL and 3/21 AML) and lenses (4/33 ALL and 4/21 AML). Conventional TBI techniques were used by 24/29 responding centers, while 5/29 used advanced optimized planning techniques.Conclusion: Across SIOPE, there is a high level of uniformity in fractionation and use of lung shielding. Practices vary regarding other organs-at-risk shielding and implementation of advanced techniques. A SIOPE radiotherapy working group will be established to define international guidelines for pediatric TBI. (C) 2020 The Author(s). Published by Elsevier B.V.