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Cited by 120Advances in Oncology and RadiotherapyAcute Lymphoblastic Leukemia researchAdvanced Radiotherapy Techniques

Historical Trends in the Use of Radiation Therapy for Pediatric Cancers: 1973-2008

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Jairam, Vikram, Roberts, Kenneth B., Yu, James B.·2013·International Journal of Radiation Oncology*Biology*Physics
DOI 10.1016/j.ijrobp.2012.10.007PMC PMC3636568
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Abstract

Purpose This study was undertaken to assess historical trends in the use of radiation therapy (RT) for pediatric cancers over the past 4 decades.Methods The National Cancer Institute's Surveillance, Epidemiology, and End Results database of the 9 original tumor registries (SEER-9) was queried to identify patients aged 0 to 19 years with acute lymphoblastic leukemia, acute myeloid leukemia, bone and joint cancer, cancer of the brain and nervous system, Hodgkin lymphoma, neuroblastoma, non-Hodgkin lymphoma, soft tissue cancer, Wilms tumor, or retinoblastoma from 1973 to 2008. Patients were grouped into 4-year time epochs. The number and percentage of patients who received RT as part of their initial treatment were calculated per epoch by each diagnosis group from 1973 to 2008.Results RT use for acute lymphoblastic leukemia, non-Hodgkin lymphoma, and retinoblastoma declined sharply from 57%, 57%, and 30% in 1973 to 1976 to 11%, 15%, and 2%, respectively, in 2005 to 2008. Similarly, smaller declines in RT use were also seen in brain cancer (70%-39%), bone cancer (41%-21%), Wilms tumor (75%-53%), and neuroblastoma (60%-25%). RT use curves for Wilms tumor and neuroblastoma were nonlinear with nadirs in 1993 to 1996 at 39% and 19%, respectively. There were minimal changes in RT use for Hodgkin lymphoma, soft tissue cancer, or acute myeloid leukemia, roughly stable at 72%, 40%, and 11%, respectively. Almost all patients treated with RT were given external beam RT exclusively. However, from 1985 to 2008, treatments involving brachytherapy, radioisotopes, or combination therapy increased in frequency, comprising 1.8%, 4.6%, and 11.9% of RT treatments in brain cancer, soft tissue cancer, and retinoblastoma, respectively.Conclusions The use of RT is declining over time in 7 of 10 pediatric cancer categories. A limitation of this study is a potential under-ascertainment of RT use in the SEER-9 database including the delayed use of RT.

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  • The use of PET imaging has allowed for elimination of external-beam radiation in many cases of Hodgkin disease, thus limiting toxicity, by more appropriately limiting external-beam radiation to those with residual tumor by PET.

    “The use of PET imaging has allowed for elimination of external-beam radiation in many cases of Hodgkin disease, thus limiting toxicity ( 94 ) by more appropriately limiting external-beam radiation to those with residual tumor by PET.”

    From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [94]

    The Discussion (page unavailable) links improved imaging and risk stratification to tailoring Hodgkin lymphoma treatment and discusses reducing radiation-related toxicity. But it does not identify PET as the imaging method or say radiation is limited to PET-positive residual tumors. It describes reduced radiation use as a possible future trend, not one observed in its study; the Results report Hodgkin lymphoma radiation use remained roughly stable at 72%. (LLM, conf=0.85)

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Authors
Jairam, V., Roberts, K. B., & Yu, J. B.
Affiliations
  • Yale University (US)
  • Yale Cancer Center (US)
Corresponding author
Yu, James B.
ORCID
Venue
International Journal of Radiation Oncology*Biology*Physics
Publisher
Elsevier BV
Published
2013-03
Volume
85
Issue
3
Pages
e151-e155
ISSN
0360-3016 (ISSN-L)
DOI
10.1016/j.ijrobp.2012.10.007
PMC
PMC3636568
OpenAlex
W2091317615
Cited by
120
References
29
Citations by year
2026: 5 · 2025: 10 · 2024: 10 · 2023: 14 · 2022: 12 · 2021: 11 · 2020: 9 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 9 · 2015: 6 · 2014: 11 · 2013: 2
FWCI
4.59
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Radiation Oncology*Biology*Physics (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Center for Research Resources (KL2RR024138)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
  • Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
Keywords
childhood cancer, radiotherapy, treatment trends, acute lymphoblastic leukemia, retinoblastoma, neuroblastoma, Wilms tumor, brain cancer, Hodgkin's disease, non-Hodgkin lymphoma, acute myeloid leukemia, brachytherapy, external beam radiotherapy, radionuclides
MeSH terms
Adolescent, Bone Neoplasms, Child, Child, Preschool, Female, Hodgkin Disease, Humans, Infant, Infant, Newborn, Lymphoma, Non-Hodgkin, Male, Neoplasms, Wilms Tumor, Neuroblastoma, Radiotherapy, Retinoblastoma, Osteosarcoma, Soft Tissue Neoplasms, Time Factors, United States, Leukemia, Myeloid, Acute, SEER Program, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Young Adult

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