{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:44:58Z","timestamp":1780389898819,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,2,12]],"date-time":"2004-02-12T00:00:00Z","timestamp":1076544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2004,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The optimal administration of radiotherapy for patients with high\u2010risk neuroblastoma (NB) currently is undefined in the context of modern therapy using myeloablative chemotherapy with autologous stem cell rescue (hematopoietic stem cell transplantation [HSCT]).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors conducted a retrospective review of the records of 21 consecutive patients with high\u2010risk NB to assess local control and toxicity of external beam radiotherapy (XRT). Therapy included multiagent induction chemotherapy and delayed surgical resection, consolidation of HSCT and local XRT, and 13\u2010<jats:italic>cis<\/jats:italic>\u2010retinoic acid maintenance therapy. XRT was delivered to the primary site, using postchemotherapy volumes, and to initial metastatic sites with 1\u20132 cm margins to 2100 centigrays (cGy) using 14 fractions administered once daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Four of 21 patients did not receive XRT due to toxic death (<jats:italic>n<\/jats:italic> = 2), disease progression before XRT (<jats:italic>n<\/jats:italic> = 1), or parental refusal (<jats:italic>n<\/jats:italic> = 1). The median time to XRT post\u2010HSCT was 54 days. Thirteen patients received a second peripheral blood stem cell infusion after completing XRT. Twelve of the 14 patients who received XRT post\u2010HSCT and for whom toxicity data were available had Grade 3\u20134 acute toxicities, including gastrointestinal toxicity (<jats:italic>n<\/jats:italic> = 8), hematologic toxicity (<jats:italic>n<\/jats:italic> = 9), and infection (<jats:italic>n<\/jats:italic> = 1). Nonrecurrent long\u2010term toxicities included prolonged nutritional deficiency (<jats:italic>n<\/jats:italic> = 9) and leg\u2010length discrepancy (<jats:italic>n<\/jats:italic> = 1). Tumors recurred in 7 of 21 patients (5 of 17 patients who received radiotherapy), either within a radiation field (<jats:italic>n<\/jats:italic> = 1) or at distant nonirradiated sites (<jats:italic>n<\/jats:italic> = 6). The estimated local failure rate was 7% (95% confidence interval [95% CI], 0\u201314%), with a 2\u2010year event\u2010free survival rate of 48% (95% CI, 26\u201370%).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Post\u2010HSCT, fractionated XRT to 2100 cGy was a tolerable and effective treatment for patients with high\u2010risk NB, and minimal recurrences were observed at designated XRT sites. Cancer 2004. \u00a9 2004 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20091","type":"journal-article","created":{"date-parts":[[2004,3,9]],"date-time":"2004-03-09T03:03:17Z","timestamp":1078801397000},"page":"1268-1275","source":"Crossref","is-referenced-by-count":46,"title":["Fractionated low\u2010dose radiotherapy after myeloablative stem cell transplantation for local control in patients with high\u2010risk neuroblastoma"],"prefix":"10.1002","volume":"100","author":[{"given":"Scott M.","family":"Bradfield","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Douglas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Hawkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean 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