Trials · Topics · Pediatric Oncology
Pediatric Oncology clinical trials
27 Pediatric Oncology trials (Radiation Oncology) summarized for fellows and board review, newest first within each disease. Each summary covers design, results, toxicity and what changed in practice.
Jump to: Medulloblastoma / CNS embryonal · Pediatric ALL · Neuroblastoma · Wilms tumor · Ependymoma · Pediatric AML / Sarcoma
Medulloblastoma / CNS embryonal (9)
- ACNS0331 JCO 2021Reducing CSI from 23.4 to 18 Gy resulted in inferior EFS and OS in average-risk medulloblastoma, despite better neurocognitive outcomes. Tumor bed boost is equivalent...
- Proton vs Photon CSI (Medulloblastoma) IJROBP 2019Proton CSI significantly reduces dose to cochlea, heart, lungs, and kidneys compared to photon IMRT while maintaining equivalent disease control. The reduced cochlear...
- Cranial RT Endocrine Deficiency JCO 2018Hypothalamic and pituitary dose are the key determinants of RT-induced endocrine deficiency in children. Dose thresholds are clearly defined: GHD sensitive at >18 Gy...
- ACNS0121 JCO 2019Conformal RT to 59.4 Gy achieved durable local control in pediatric ependymoma, particularly after gross total resection. The 1.0 cm CTV margin with conformal...
- ACNS0121 Neurocognitive JCO 2015Conformal RT for pediatric ependymoma is associated with progressive neurocognitive decline, particularly in younger children. The magnitude of IQ decline (~1.5...
- SFOP M4 Neuro Oncol 2013Pre-irradiation chemotherapy achieved high response rates and feasible delivery in medulloblastoma but did not clearly improve outcomes over RT alone in historical...
- CCG A9961 JCO 2006Carboplatin substitution for CCNU provided equivalent EFS and OS in standard-risk medulloblastoma. Both regimens produced excellent outcomes (~80% 5-yr EFS)...
- Baby POG I JCO 2005Delaying RT with chemotherapy in infants with medulloblastoma resulted in inferior tumor control compared to immediate RT, though chemotherapy allowed RT deferral in...
- POG 8631/CCG 923 JCO 2000Reduced-dose CSI (23.4 Gy) combined with adjuvant chemotherapy achieved superior EFS compared to standard 36 Gy CSI alone in standard-risk medulloblastoma...
Pediatric ALL (6)
- AALL0434 JCO 2020Nelarabine significantly improved DFS and OS in T-ALL when added to augmented BFM chemotherapy. This established nelarabine-containing augmented BFM as the standard...
- AALL0232 JCO 2016Dexamethasone did not improve EFS over prednisone in high-risk B-ALL but significantly increased osteonecrosis, particularly in adolescents. The low CNS relapse rate...
- Testicular RT in ALL Pediatr Blood Cancer 2011Bilateral testicular RT 20-24 Gy with re-induction chemotherapy achieves excellent local control for isolated testicular ALL relapse. Late isolated testicular relapse...
- POG 9412 Blood 2009Reduced-dose cranial RT (18 Gy) is equivalent to 24 Gy for CNS control in high-risk ALL with augmented systemic chemotherapy, with better neurocognitive outcomes....
- Total Therapy XV NEJM 2009Prophylactic cranial RT can be completely eliminated in childhood ALL treatment using modern risk-adapted intensive chemotherapy with intrathecal therapy, with...
- Ocular RT in ALL Leukemia 2008Orbital RT 24-30 Gy effectively controls ocular disease and preserves vision in the majority of ALL patients with ocular involvement when administered promptly before...
Neuroblastoma (5)
- ANBL0532 JAMA 2019Tandem HDCT significantly improved EFS versus single HDCT in high-risk neuroblastoma, without a significant OS benefit at this follow-up. Tandem consolidation became...
- ANBL0532 Dose-Escalation Analysis JCO 2020Local RT 21.6 Gy to the primary site provides acceptable local control in high-risk neuroblastoma. Dose escalation above 21.6 Gy does not appear to improve local...
- IMRT vs Conventional Neuroblastoma RT IJROBP 2013IMRT achieves equivalent target coverage and local control compared to conventional RT in neuroblastoma while significantly reducing dose to critical abdominal...
- CCG 3891 JCO 2009Both myeloablative HDCT and isotretinoin maintenance independently improved EFS in high-risk neuroblastoma. This established the paradigm of HDCT consolidation...
- CCG 3891 RT Analysis JCO 2009Local RT to the primary site is an important component of neuroblastoma therapy - omission results in higher local failure rates. Doses around 21.6 Gy became the...
Wilms tumor (4)
- AREN0533 JCO 2018Risk stratification based on blastemal predominance successfully identifies FHWT patients requiring treatment intensification. Escalation to Regimen M improved...
- UKW-3 Eur J Cancer 2006Pre-operative chemotherapy significantly reduces intraoperative tumor rupture and downstages tumors, resulting in less whole-abdominal RT with equivalent long-term...
- NWTS-3 Cancer 1989RT dose for stage III Wilms tumor was safely reduced from 20 to 10.8 Gy without loss of efficacy. Stage II favorable histology can be treated without RT. Doxorubicin...
- NWTS-2 Cancer 1981Doxorubicin significantly improved outcomes for stage III-IV Wilms tumor. Stage I favorable histology could be treated without RT - confirming NWTS-1 findings. This...
Ependymoma (2)
- MGH Proton Ependymoma Neuro Oncol 2013Proton RT achieves local control and survival outcomes comparable to photon conformal RT in pediatric ependymoma while significantly reducing dose to critical normal...
- St. Jude Ependymoma Series Lancet Oncol 2009GTR followed by conformal RT achieves excellent local control and survival in pediatric ependymoma. Omission of CSI for M0 disease was validated - spinal failure rate...
Pediatric AML / Sarcoma (1)
- Myeloid Sarcoma RT IJROBP 2012RT provides excellent local control for myeloid sarcoma and may improve OS when combined with systemic AML-type chemotherapy. Isolated myeloid sarcoma should be...