{"doi":"10.3390/curroncol32030124","title":"Hypofractionated Palliative Radiotherapy for Relapsed and Refractory High-Risk Neuroblastoma","abstract":"Introduction: While palliative radiotherapy (RT) is frequently used in the management of relapsed/refractory high-risk neuroblastoma (HR-NBL); outcomes after palliative hypofractionated RT (hypo-RT) remain poorly characterized. Methods: We conducted a multi-institutional retrospective study of 38 patients who were diagnosed with HR-NBL between 1997 and 2021 and received palliative RT. Conventional RT (conv-RT) and hypo-RT were defined as palliative treatment courses using dose ≤2 or >2 Gy per fraction, respectively. The primary outcome was cumulative incidence of in-field progression using Gray’s test. Univariate analyses were performed using the Cox proportional hazards model. Results: When analyzing by first course of palliative RT, 16 patients received conventionally fractionated RT (43%) and 21 received hypo-RT (57%). Clinical characteristics were similar between the two groups. With a median follow-up of 10.3 months (range: 0.3–104.0), the cumulative incidence of in-field progression was not statistically significantly different between hypo-RT and conv-RT (30% vs. 20% at 10 months; p = 0.80). Clinical response, defined as symptomatic improvement or decrease in the size of the lesion, was not statistically different between the two groups (92% conv-RT vs. 90% hypo-RT; p = 1.00). No grade ≥4 toxicities were observed. On univariate analysis, hypo-RT (HR 1.50; 95% CI 0.47–4.76; p = 0.493) was not statistically significantly associated with time to in-field progression, but MYCN amplification was associated with significantly longer time to in-field progression (HR: 0.20; 95% CI: 0.05–0.77; p = 0.020). Conclusions: We found no statistically significant difference in cumulative incidence of in-field progression and clinical outcomes between the conv-RT and hypo-RT groups. Palliative hypo-RT can be considered for relapsed/refractory HR-NBL, especially when shorter treatments may offer improved quality of life.","journal":"Current Oncology","year":2025,"id":543213,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9428,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":703389,"name":"Karen J. Marcus","orcid":"0000-0001-5156-6336","position":1,"is_corresponding":false},{"id":305844,"name":"Steven G. DuBois","orcid":"0000-0003-0882-738X","position":2,"is_corresponding":false},{"id":274716,"name":"Paul J. Catalano","orcid":"0000-0002-1105-8852","position":3,"is_corresponding":false},{"id":564617,"name":"Suzanne Shusterman","orcid":"0000-0002-5988-1792","position":4,"is_corresponding":false},{"id":1297586,"name":"Myrsini Ioakeim‐Ioannidou","orcid":null,"position":5,"is_corresponding":false},{"id":295554,"name":"Hesham Elhalawani","orcid":"0000-0001-9848-2623","position":6,"is_corresponding":false},{"id":477587,"name":"Torunn I. Yock","orcid":"0000-0001-6408-8011","position":7,"is_corresponding":false},{"id":290989,"name":"Shannon M. MacDonald","orcid":"0000-0001-9092-1337","position":8,"is_corresponding":false},{"id":1407,"name":"Daphne A. Haas‐Kogan","orcid":"0000-0002-2378-4800","position":9,"is_corresponding":false},{"id":257989,"name":"Kevin X. Liu","orcid":"0000-0003-2071-5137","position":10,"is_corresponding":false},{"id":846011,"name":"Ellery Koelker-Wolfe","orcid":"0000-0002-5164-643X","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T02:53:04.088079Z","pmid":"40136328","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}