Letter to the Editor

Radiotherapy Dose Fractionation in Pediatric Langerhans Cell Histiocytosis

Authors: Christopher D. Jahraus, MD, Suzanne Russo, MD, José Peñagarícano, MD, Anupam Routh, MD, William St Clair, MD, PhD

Abstract

Langerhans cell histiocytosis (LCH) is an uncommon disease characterized by idiopathic proliferation of dendritic histiocytes, most commonly diagnosed in children younger than 20 years of age. Though LCH is radioresponsive, the use of radiation has been restricted in children, due to concerns about growth, developmental, and other late toxicities and the availability of less toxic treatment. Nonetheless, situations arise in which critical structures are threatened or primary therapy fails, and the risks of using radiotherapy (RT) are outweighed by probable benefit.1,2 Modern series have used RT doses of 600 to 1,000 cGy,1–3 however, proper dose fractionation is poorly established, with no published results correlating fraction size with clinical outcome. Thus, we retrospectively analyzed outcomes according to the RT dose fraction used.

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References

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