PALLIATIVE RADIOTHERAPY IN THE MANAGEMENT OF ADVANCED PEDIATRIC MALIGNANCIES

Abstract

Purpose: To evaluate the role of palliative radiotherapy in the management of advanced pediatric malignancies.

Methods: Patients coming to the department of radiotherapy S.M.S Hospital were included in the study. Out of 40 patients 36 pediatric patients were selected between Nov 2010 to Nov 2012. 4 Patients were excluded from the study. Inclusion Criteria (1) Advanced Pediatric Malignancy (2) Age 1 to 20 yrs (3) Consents of parents (4) Sympto- matic Patients.Exclusion Criteria (1) Early stage Disease (2)Asymptomatic Patients(3)Age <1 yrs and >20 yrs(4)No Consent All of theses 36 children received palliative external beam radiotherapy by cobalt 60. . The two dose sche- dules were used (1) 625cGy in 3 fractions (2) 30 Gy in 10 fractions.

Results: There were 26 boys and 10 girls in the age group of 1 to 19 years, with a median age of 14 years (range of 1-19 years). Predominant symptoms were swelling, pain, bleeding, and weakness of limbs. The median duration of symptoms was 80 days (range of 4-40 days). The histological diagnosis was malignant round cell tumors (17); reti- noblastoma (6); neuroblastoma (5); and Ewing's sarcoma (8). All patients presented with advanced stages of disease. Out of 36 patients 18 (50%) had disseminated disease at presentation. Some patients underwent surgery and chemo- therapy and all patients received palliative radiotherapy. Three patients showed complete resolution, 18 patients showed good, while 14 patients had little, 1 did not have any relief in their symptoms. At the completion of treat- ment, 16 patients had partial response, 8 patients had progressive disease, 10 had stable disease and 2 patients had complete response.

Conclusions: So the role of radiotherapy is very important as palliative modality in children with locally advanced lesions.