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10.1002/ajh.23784

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suck abstract from ncbi


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pmid24912665
      Am+J+Hematol 2014 ; 89 (10 ): 992-7
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  • Cranial radiation for pediatric T-lineage acute lymphoblastic leukemia: a systematic review and meta-analysis #MMPMID24912665
  • Kelly MJ ; Trikalinos TA ; Dahabreh IJ ; Gianferante M ; Parsons SK
  • Am J Hematol 2014[Oct]; 89 (10 ): 992-7 PMID24912665 show ga
  • There are heterogeneous approaches to cranial radiation therapy (CRT) for T-lineage acute lymphoblastic leukemia (T-ALL). We performed a systematic review of studies that specified a radiation strategy and reported survival for pediatric T-ALL. Our analysis included 62 publications reporting 78 treatment groups (patient n = 5844). The average event-free survival (EFS) was higher by 6% per 5 years (P < 0.001). Adjusting for year, EFS differed by radiation strategy. Compared to the reference group (CRT for all) which had a year-adjusted EFS of 65% (95% confidence interval, CI: 61-69%) the adjusted EFS was significantly worse (rate difference (RD)?=?-9%, 95% CI: -15 to -2%) among studies that used a risk-directed approach to CRT (P = 0.004). The adjusted EFS for the other strategies were not significantly different compared to the reference group: CRT for central nervous system positive patients only (RD = -3%, 95% CI: -14 to 7%, P = 0.49); CRT omitted for all patients (RD = 5%, 95% CI: -4 to 15%, P = 0.33). CRT may not be necessary with current chemotherapy for T-ALL. These findings, however, are susceptible to bias and caution should be applied in drawing conclusions on the comparative effectiveness of alternative CRT strategies.
  • |*Skull [MESH]
  • |Adolescent [MESH]
  • |Child [MESH]
  • |Child, Preschool [MESH]
  • |Disease-Free Survival [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Infant [MESH]
  • |Male [MESH]
  • |Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/*mortality/*radiotherapy [MESH]


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