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Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma

Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma
Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma
Purpose
To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial.

Methods and Materials
Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded.

Results
Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011).

Conclusions
Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.
0360-3016
292-300
Kennedy, C.
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Bull, K.
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Chevignard, M.
94db51d1-3f45-492d-bd27-6fc087613e9e
Culliford, D.
25511573-74d3-422a-b0ee-dfe60f80df87
Dörr, H.G.
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Doz, F.
9ec53654-565f-49be-a2fc-189aa7929913
Kortmann, R.
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Lannering, B.
e8687c53-1dc4-48d2-8768-a4a13dde4c43
Massimino, M.
d00c8649-a37e-4cf9-be5b-7379f6fb97bb
Gutierrez, A.N.
d6b1b74f-fb90-496c-9892-7f79137a47ff
Rutkowski, S.
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Spoudeas, Helen A.
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Calaminus, G.
03fdb71e-4701-4708-8fca-dc63a9cf4fad
on behalf of the PNET4 study group of the Brain Tumour Group of The European branch of the International Society of Paediatric Oncology (SIOP-E)
Kennedy, C.
7c3aff62-0a86-4b44-b7d7-4bc01f23ec93
Bull, K.
751f8b25-29ba-4d4f-96e2-6c339a83a47f
Chevignard, M.
94db51d1-3f45-492d-bd27-6fc087613e9e
Culliford, D.
25511573-74d3-422a-b0ee-dfe60f80df87
Dörr, H.G.
f827dc05-30bf-4be2-9694-193adb46f694
Doz, F.
9ec53654-565f-49be-a2fc-189aa7929913
Kortmann, R.
2084eb25-0578-4bc3-96da-78fbb79b382d
Lannering, B.
e8687c53-1dc4-48d2-8768-a4a13dde4c43
Massimino, M.
d00c8649-a37e-4cf9-be5b-7379f6fb97bb
Gutierrez, A.N.
d6b1b74f-fb90-496c-9892-7f79137a47ff
Rutkowski, S.
86635292-09e0-43e6-892e-61800c3d1d48
Spoudeas, Helen A.
8185f4fd-9c6f-42e9-aa77-e6b51c759acc
Calaminus, G.
03fdb71e-4701-4708-8fca-dc63a9cf4fad

Kennedy, C., Bull, K., Chevignard, M., Culliford, D., Dörr, H.G., Doz, F., Kortmann, R., Lannering, B., Massimino, M., Gutierrez, A.N., Rutkowski, S., Spoudeas, Helen A. and Calaminus, G. , on behalf of the PNET4 study group of the Brain Tumour Group of The European branch of the International Society of Paediatric Oncology (SIOP-E) (2014) Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma. International Journal of Radiation: Oncology, Biology, Physics, 88 (2), 292-300. (doi:10.1016/j.ijrobp.2013.09.046).

Record type: Article

Abstract

Purpose
To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial.

Methods and Materials
Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded.

Results
Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011).

Conclusions
Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.

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e-pub ahead of print date: 13 November 2013
Published date: 2014
Organisations: Primary Care & Population Sciences, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 359581
URI: https://eprints.soton.ac.uk/id/eprint/359581
ISSN: 0360-3016
PURE UUID: 2fb6e637-2f63-485c-bf79-bd316c5ef1dd
ORCID for K. Bull: ORCID iD orcid.org/0000-0002-5541-4556
ORCID for D. Culliford: ORCID iD orcid.org/0000-0003-1663-0253

Catalogue record

Date deposited: 05 Nov 2013 10:16
Last modified: 19 Nov 2019 01:53

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