A Retrospective Evaluation of the Benefit of Referring Pediatric Cancer Patients to an External Proton Therapy Center

Background Pediatric cancer patients requiring radiation therapy (RT) have been routinely assessed and referred to proton therapy (PT) at an external institution. The benefit of the delivered PT compared to the state‐of‐the‐art intensity modulated x‐ray RT (XT) at the home institution was evaluated....

Full description

Saved in:
Bibliographic Details
Published in:Pediatric blood & cancer 2016-02, Vol.63 (2), p.262-269
Main Authors: Munck af Rosenschold, Per, Engelholm, Svend A., Brodin, Patrik N., Jørgensen, Morten, Grosshans, David R., Zhu, Ronald X., Palmer, Matthew, Crawford, Cody N., Mahajan, Anita
Format: Article
Language:English
Subjects:
Adolescent
Central Nervous System Neoplasms - radiotherapy
Child
Child, Preschool
Cranial Irradiation - methods
Female
Hematology
Humans
Male
neurocognitive dysfunction
Oncology
Organs at Risk
pediatric cancer
Pediatrics
proton therapy
Proton Therapy - methods
radiation therapy
radiobiological risk estimates
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
Referral and Consultation
Retrospective Studies
Spinal Cord - radiation effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Pediatric cancer patients requiring radiation therapy (RT) have been routinely assessed and referred to proton therapy (PT) at an external institution. The benefit of the delivered PT compared to the state‐of‐the‐art intensity modulated x‐ray RT (XT) at the home institution was evaluated. Procedure Twenty‐four consecutive children referred for PT during 2010–2013 for craniospinal (CSI, n = 10), localized intracranial (IC, n = 7), head/neck (HN, n = 4) or parameningeal (PM, n = 3) lesions were included. The median age was 8 years (2–16 years). XT plans were generated for each patient, blinded to the PT delivered. Dosimetry, estimated growth hormone deficiency (GHD), and neurocognitive dysfunction (NCD) risks were compared for PT and XT (Wilcoxon). Results PT started (median) 5 weeks (± 1.3 weeks, 95% CI) after referral. For CSI patients, PT was clearly superior to XT plans with median dose reductions for the heart, lungs and thyroid of 17, 2.5 and 18 Gy, respectively (P = 0.005). The median estimated NCD and GHD risks were 1–3 (max 16) and 2 (max 61) percentage points, respectively, lower for PT compared to XT. The median of the mean doses to the brain, cochleae and pituitary gland was lower with PT than XT for the IC, H/N and PM patients (P 
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.25768