Feasibility of Proton Beam Therapy for Infants with Brain Tumours: Experiences from the Prospective KiProReg Registry Study
| Autor: | S. Peters, C. Blase, S. Frisch, Michael C. Frühwald, T. Steinmeier, Beate Timmermann, Christian Bäumer, Danny Jazmati, S. Schulze Schleithoff, Stefan Rutkowski, Stephan Tippelt, D. Ahamd Khalil |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Ependymoma
Pediatrics medicine.medical_specialty medicine.medical_treatment Medizin 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Glioma Proton Therapy medicine Humans Radiology Nuclear Medicine and imaging Registries Cerebellar Neoplasms Child Adverse effect Retrospective Studies Medulloblastoma Brain Neoplasms business.industry Infant Cancer Common Terminology Criteria for Adverse Events medicine.disease Radiation therapy Oncology Child Preschool 030220 oncology & carcinogenesis Feasibility Studies Complication business |
| Zdroj: | Clinical Oncology. 33:e295-e304 |
| ISSN: | 0936-6555 |
| Popis: | Aims Proton beam therapy (PBT) has increasingly been applied for the treatment of young children when radiotherapy is needed. The treatment requires intensive multimodality care and is logistically demanding. In this analysis, we evaluated our experiences in treating infants with tumours of the central nervous system with PBT. Materials and methods Children younger than 2 years of age treated with PBT for central nervous system tumours enrolled in the prospective registry study KiProReg were retrospectively analysed. Information on patient characteristics, treatment, toxicities and outcome were evaluated. Adverse events were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE V4.0) before, during and after PBT. Results Between September 2013 and June 2018, 51 infants were eligible. The median age was 19 months (range 11–23 months) at the time of PBT. Tumour entities were ependymoma (51.0%), atypical teratoid rhabdoid tumour (39.0%), high-grade glioma (6.0%), pineoblastoma (2.0%) and medulloblastoma (2.0%). The prescribed median total dose was 54.0 Gy (range 45.0–59.4 Gy). Most received local radiotherapy. In four patients, craniospinal irradiation followed by a boost to the local tumour bed was applied. The median follow-up time was 42.0 months (range 7.3–86.2 months). The estimated 3-year local control, progression-free survival and overall survival rates for all patients were 62.7, 47.1 and 76.5%, respectively. During radiotherapy, 24 events of higher-grade (CTCAE ≥ °III) toxicities were reported. Interruption of radiotherapy for more than 2 days was due to infection (n = 3) or shunt complication (n = 2). Unexpected hospitalisation during radiotherapy affected 12 patients. Late adverse events attributable to radiotherapy included endocrinopathy (CTCAE °II; 7.8%), new onset of hearing loss (CTCAE °III; 5.8%) and visual impairment (CTCAE °IV; 1.9%). Transient radiation-induced imaging changes occurred in five patients (9.8%). Conclusions Our study indicates that PBT is feasible for very young children with central nervous system tumours, at least in the short term. However, it requires challenging interdisciplinary medical care and high logistical effort. For evaluation of late effects, longer follow-up and evaluation of neurocognitive outcome are desirable. More data have to be gathered to further define the role of radiotherapy in infants over time. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect