A review of dosimetric and toxicity modeling of proton versus photon craniospinal irradiation for pediatrics medulloblastoma.
Acta Oncol
; 56(8): 1031-1042, 2017 Aug.
Article
in En
| MEDLINE
| ID: mdl-28509599
ABSTRACT
BACKGROUND:
Craniospinal irradiation (CSI) is the standard radiation therapy treatment for medulloblastoma. Conventional CSI photon therapy (Photon-CSI) delivers significant dose to surrounding normal tissue (NT). Research into pediatric CSI with proton therapy (Proton-CSI) has increased, with the aim of exploiting the potential to reduce NT dose and associated post-treatment complications. This review aims to compare treatment outcomes of pediatric medulloblastoma patients between Proton- and Photon-CSI treatments. MATERIAL ANDMETHODS:
A search and review of studies published between 1990 and 2016 comparing pediatric (2-18 years) medulloblastoma Proton- and Photon-CSI in three aspects - normal organ sparing and target coverage; normal organ dysfunction and second malignancy risks - was completed.RESULTS:
Fifteen studies were selected for review and the results were directly compared. Proton-CSI reported improved out-of-field organ sparing while target coverage improvements were inconsistent. Normal organ dysfunction risks were predicted to be lower following Proton-CSI. Secondary malignancy risks (SMRs) were generally lower with Proton-CSI based on several different risk models.CONCLUSIONS:
Proton-CSI conferred better treatment outcomes than Photon-CSI for pediatric medulloblastoma patients. This review serves to compare the current literature in the absence of long-term data from prospective studies.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebellar Neoplasms
/
Neoplasms, Second Primary
/
Photons
/
Craniospinal Irradiation
/
Proton Therapy
/
Medulloblastoma
/
Models, Theoretical
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
Language:
En
Journal:
Acta Oncol
Journal subject:
NEOPLASIAS
Year:
2017
Document type:
Article
Affiliation country:
Ireland