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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 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.