International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Radiation Therapy For Pediatric Head And Neck Ewing Sarcoma: A 13-Year Experience From a Tertiary Care University Hospital In Pakistan","authors":"M. Tariq,&nbsp;M. Hina,&nbsp;Y. Ahmed,&nbsp;A. Abbasi,&nbsp;A. Hafiz,&nbsp;N. Ali,&nbsp;S. Abrar,&nbsp;B. Qureshi","doi":"10.1016/j.ijrobp.2024.11.054","DOIUrl":"10.1016/j.ijrobp.2024.11.054","url":null,"abstract":"<div><h3>Objectives</h3><div>Ewing's sarcoma(ES) in head and neck region is an uncommon yet challenging entity, and accounts for 1%-4% of all ES cases. Our study aims to assess the clinicodemographic and therapeutic features of pediatric patients irradiated for head and neck Ewing sarcoma (HN-ES) at our centre.</div></div><div><h3>Methodology</h3><div>This is a retrospective review of the medical records of patients aged ≤18 years, with histologically proven HN-ES irradiated at Radiation Oncology department of Aga Khan University Hospital, between 2010 – 2023. Clinico-demographic features including age, gender, head and neck subsite, and RT details such as intent, total RT dose, radiation treatment duration and treatment gaps were systematically collected and stored in password-protected datasheet.</div></div><div><h3>Results</h3><div>Total (n=20) pediatric patients with HN-ES underwent irradiation at our facility between 2010–2023. Majority were females(n=13), with a mean age of 9.5 years(±3.83). Three patients received RT under general anesthesia. Subsite involvement included orbit (n=5), mandible (n=4), paranasal sinus (n=2), pharynx (n=2), and scalp (n=2), with cervical spine, nasal cavity, maxilla, and mastoid each affected in one case. Definitive RT was provided to 17 patients, while adjuvant RT was administered to n=3 patients. Intensity-modulated radiation therapy(n=13) was the most common planning technique, followed by Volumetric-arc therapy (n=4) and three-dimensional conformal RT(n=3). The mean radiation dose was 5360 cGy, with a regimen of 5580 cGy/31 fractions being predominant(n=14). Eleven patients had a single-phase RT plan, while nine had a two-phase plan. The mean treatment duration was 51.25 days, with treatment gaps identified in n=15 patients, primarily attributed to neutropenia(n=8), and infective causes(n=7), with a median duration of 5 days(range:1–14 days).</div></div><div><h3>Conclusion</h3><div>HN-ES is exceedingly rare, and even small single-center experiences contribute to the growing body of evidence. Managing HN-ES poses significant challenges in achieving local control while preserving functional outcomes, underscoring the importance of multidisciplinary care.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e15"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Status in the Era of New Molecular Diagnostics: Insights from a Single-Center Case Series Report in China","authors":"J. Li ,&nbsp;R. Ai ,&nbsp;M. Lai ,&nbsp;R. Al","doi":"10.1016/j.ijrobp.2024.11.026","DOIUrl":"10.1016/j.ijrobp.2024.11.026","url":null,"abstract":"<div><h3>Background</h3><div>With the publication of the \"2016 WHO Classification of Tumors of the Central Nervous System,\" attention to the molecular and biochemical characteristics of brain tumors has increased among oncologists. Surgical biopsy provides valuable information on molecular markers of brain gliomas, aiding in further personalized treatment. This retrospective study aimed to elucidate the real-world application of surgery in Diffuse Intrinsic Pontine Glioma (DIPG) in the era of new molecular diagnostics.</div></div><div><h3>Objective</h3><div>To assess the surgical landscape in the treatment of DIPG patients from Jan 2017 to Feb 2023 at the Cancer Center of Guangdong Sanjiu Brain Hospital.</div></div><div><h3>Method</h3><div>Clinical data, including patient family consent for surgery, surgical procedure selection, complications, postoperative treatment, pathology findings, and survival outcomes, were retrospectively reviewed.</div></div><div><h3>Results</h3><div>From February 2017 to February 2023, Guangdong Sanjiu Brain Hospital's oncology department treated a total of 184 cases, with 108 patients (58.6%, 108/184) undergoing surgery. Medical records indicated that surgery was introduced and discussed with 97.2% (179/184) of patients, among whom 110 expressed a willingness to undergo surgery, and 108 eventually underwent the procedure. Of the completed surgeries, 65.8% (71/108) were open surgeries, and 34.2% (37/108) involved the use of the Rosa robot. Patient ages ranged from 2 to 61 years, with a median age of 9 years. Among patients aged 18 and above (n=60), 78.3% (47/60) underwent surgery, while among those below 18 years (n=124), 49.1% (61/124) underwent surgery, showing a statistically significant difference between the two groups (P&lt;0.05). The median time from surgery to radiotherapy was 19 days for open biopsy and 7 days for stereotactic biopsy. In the open biopsy group, 20 patients experienced increased cranial nerve dysfunction from preoperative to postoperative, with three patients requiring ICU stays exceeding one month. All 108 patients obtained pathological diagnoses, with 79 cases being diffuse midline gliomas and 29 cases classified as other gliomas. The latter included 4 cases of pilocytic astrocytoma, 16 cases of grade 2 diffuse astrocytoma, 7 cases of grade 3 glioma, and 2 cases of pediatric glioblastoma. Seven patients received targeted therapy based on second-generation sequencing results, involving drugs such as ribociclib, rigosertib, cabozantinib, and ONC201.</div></div><div><h3>Conclusion</h3><div>In contrast to data from a decade ago, oncologists' willingness to perform brainstem surgery has increased. Surgical biopsy is more likely in older patients with brainstem lesions. Compared to open biopsy, stereotactic biopsy has fewer side effects and allows for rapid initiation of radiotherapy. Obtaining lesion tissue during surgery brings hope for new treatments and future research for patients.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e6"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group3 Medulloblastoma with Bone Marrow and Abdominal Cavity Metastasis: A Case Report","authors":"S. Li ,&nbsp;L. Chen ,&nbsp;L. Wang ,&nbsp;Y. Zhang ,&nbsp;H. Kang ,&nbsp;M. Ye ,&nbsp;M. Lai ,&nbsp;R. Al","doi":"10.1016/j.ijrobp.2024.11.061","DOIUrl":"10.1016/j.ijrobp.2024.11.061","url":null,"abstract":"<div><div>Medulloblastoma is an infratentorial primitive neuro-ectodermal tumour, which is commonly occurring in childhood. It often spreads through the cerebrospinal fluid pathways with a very low rate of systemic metastases. Extra-central nervous system metastases have a poor prognosis in medulloblastoma. Here, we reported a case of Group3 medulloblastoma with bone marrow and abdominal cavity metastasis.</div></div><div><h3>Methods</h3><div>A 10-year-old girl complained of headache, dizziness, vomiting and nausea. Magnetic resonance imaging(MRI) of the brain showed a large mass in the fourth ventricle and obstructive hydrocephalus. The surgery was performed to remove the mass and ventriculoabdominnal shunt was performed for obstructive hydrocephalus. Histological verification was proven classic medulloblastoma and next-generation sequencing confirmed molecular group of Gruop3 with MYC amplication. Radiotherapy was subsequently performed one month after the surgery.</div></div><div><h3>Results</h3><div>During the radiotherapy, brain MRI showed metastasis on the surface of the brain, which confer a poor prognosis. After the radiotherapy According to the therapeutic schedule, She would accept chemotherapy one month after the radiotherapy. But She suffered severe bone marrow suppression manifested as anaemia and thrombocytopenia, which can not be improved by medication and blood transfusion. A bone marrow aspiration was subsequently performed, and bone marrow smear showed large numbers of tumor cells at high magnification and was lack of normal hematopoietic cells. The girl was deteriorating rapidly with jaundice, ascites, hepatosplenomegaly and pancreatitis after the bone marrow aspiration. We found a lot of tumor cells in the bleeding tendency ascites and finally confirmed bone marrow and abdominal cavity metastasis concurrently.</div></div><div><h3>Conclusion</h3><div>Eventually, She died less than a month after the metastasis and the overall survival was only 6 months. This typical case demonstrated severe bone marrow suppression of unknown origin should caused alarm and be performed bone marrow aspiration as soon as possible. The prognosis of medulloblastoma with extra-central nervous system metastases is poor and people may die in months.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e17"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Thousand Data Points, One Clear Message: SFRT-1000 Demonstrates the Real-World Effectiveness of Simulation-Free Palliative Radiation Therapy","authors":"Melissa O'Neil MSc, MRT(T),&nbsp;David A. Palma MD, PhD","doi":"10.1016/j.ijrobp.2024.10.012","DOIUrl":"10.1016/j.ijrobp.2024.10.012","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages 596-598"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose Escalation in Pediatric Pelvic Ewing's Sarcoma: Insights from a National Training Initiative","authors":"L. Ollivier ,&nbsp;F. Goudjil ,&nbsp;S. Raucoules ,&nbsp;C. Moignier ,&nbsp;D. Maneval ,&nbsp;C. Bartau ,&nbsp;G. Hangard ,&nbsp;D. Trauchessec ,&nbsp;V. Anthonipillai ,&nbsp;C. Lafond ,&nbsp;W. Gehin ,&nbsp;T. Lacornerie ,&nbsp;L. Claude ,&nbsp;G. Beldjoudi","doi":"10.1016/j.ijrobp.2024.11.020","DOIUrl":"10.1016/j.ijrobp.2024.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>The Inter Ewing-1 trial investigates dose escalation in definitive radiotherapy (randomization 54Gy versus 64.8Gy). Before opening the trial, a national training initiative was conducted by the French Pediatric Radiotherapy Group (GFRP) to assess dosimetric discrepancies in definitive RT with dose escalation.</div></div><div><h3>Methods and Materials</h3><div>A large non-operated pelvic pediatric case of Ewing's sarcoma was selected. Delineated structures associated with CT-scan were distributed to participants, all of whom were accredited for pediatric radio- and/or proton-therapy. Treatment planning involved a simultaneous integrated boost: 54Gy in 30 fractions (1.80Gy/fraction) for the pre-chemotherapy tumor volume and 63.9Gy (2.13Gy/fraction) for the post-chemotherapy volume. Dose constraints for organs-at-risk and target coverage were provided. All treatment plans for photons and protons were collected, analyzed for minor and major deviations and compared using 21 dosimetric criteria.</div></div><div><h3>Results</h3><div>Eleven French centers participated, submitting 14 plans (10 photon/4 proton plans). One photon plan showed a minor deviation in CTV coverage (V60.7GyCTV=98.8%, expected value=100%), and another one exhibited two minor deviations in organ-at-risk constraints (V55GyBowel=32cc [limit:28 cc] and V50GyRectum=52.4% [limit:50%]). No significant difference was observed between photons and protons in target coverage for PTV63.9Gy(p=0.95) and CTV63.9Gy(p=0.66), as well as in sparing the most critical organs. However, significant differences were reported in favor of protons regarding the integral dose criterion (p&lt;0.01), DmeanBowel(9.9±1.1Gy for photons vs 4.1±1.3 Gy for protons, p&lt;0.01), and DmeanAnalCanal(3.9±0.7Gy for photons vs 2.2±0.9Gy for protons, p&lt;0.01).</div></div><div><h3>Conclusion</h3><div>This national training initiative provided French centers conducting pediatric radio/proton-therapy with an initial insight into the Ewing-1 protocol. Analysis showed a good treatment planning homogeneity between the centers and a successful adhesion to the dose escalation arm constraints. Protons did not demonstrate considerable advantages for this particular clinical case except with respect to the limitation of integral dose.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e4"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Acute Side Effects in Hodgkin's Lymphoma Patients Undergoing Radiation Therapy: A Comparison of Sequential and Non-Sequential RT Approaches","authors":"M. Hina ,&nbsp;M. Tariq ,&nbsp;F. Shakeel ,&nbsp;S. Arif ,&nbsp;Y. Ahmed ,&nbsp;S. Abrar ,&nbsp;A. Hafiz ,&nbsp;N. Ali ,&nbsp;A. Abbasi ,&nbsp;B. Qureshi","doi":"10.1016/j.ijrobp.2024.11.038","DOIUrl":"10.1016/j.ijrobp.2024.11.038","url":null,"abstract":"<div><h3>Objective</h3><div>To assess acute effects in radiation therapy (RT) for Hodgkin's Lymphoma (HL) after chemotherapy.</div></div><div><h3>Method</h3><div>HL patients treated from March 2017-January 2024 were retrospectively analyzed. Complete data for 63 out of an initial cohort of 100 patients was identified via a comprehensive review of treatment files and online database. Demographic, RT details along with acute effect profile was recorded.</div></div><div><h3>Result</h3><div>Among patients, 44.4%(n=28) were &lt;10 years, 42.9%(n=27) 10-15 years and 12.7%(n=8) &gt;15 years. Males constituted 77.8%(n=49) and females 22.2%(n=14). There were 3.2%(n=2) Stage I, 33.3%(n=21) Stage II, 38.1%(n=24) Stage III, 25.4%(n=16) Stage IV and 22.2%(n=18) Relapsed/Refractory cases.</div><div>RT included 3D-Conformal Radiation Therapy (3DCRT; 23.8%, n=15) and Intensity Modulated Radiation Therapy/Volumetric Modulated Arc Therapy (IMRT/VMAT; 76.2%, n=48) with a median dose of 2980 cGY in 42.9%(n=27). Sites were categorized into supradiaphragmatic only 30.2%(n=19), concurrent 60.3%(n=38), and infradiaphragmatic only 9.5%(n=6). Frequently treated sites included cervical region (88.95%, n=55), mediastinum (65.1%, n=41), para-aortic (58.7%, n=37), spleen (41.3%, n=26), axilla (39.7%, n=25), inguinal (17.5%, n=11), pelvis (14.3%, n=9) and skeletal region (9.5%, n=6). Among patients with both supra and infra diaphragmatic disease, 74.6% (n=47) received concurrent RT to both regions. Sequential RT for either lesion was done in 25.4% (n=16) patients. The majority (66.7%, n=42) experienced no treatment gaps.</div><div>In sequential RT, 11%(n=7) reported no acute effects, 6.3%(n=4) G1 mucositis, 1.6%(n=1) dysphagia and G1 dermatitis each. In non-sequential RT, 38.1%(n=24) reported no acute effects, 22.2%(n=14) G1 dermatitis, 17.5%(n=11) dysphagia, 11.1%(n=7) G1 mucositis and G2 mucositis each, 9.5%(n=6) vomiting, 7.9%(n=5) nausea, 4.8%(n=3) G2 dermatitis, 1.6%(n=1) G3 mucositis and nodal swelling each.</div></div><div><h3>Conclusion</h3><div>Our study highlights the reduced incidence of acute effects with the introduction of conformal RT techniques. Even among those receiving concurrent supra and infra diaphragmatic RT, majority experienced no acute effects, and those who did, tolerated them well.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e10"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to Schuler et al.","authors":"Katrina Woodford PhD,&nbsp;Susan Harden DM","doi":"10.1016/j.ijrobp.2024.11.085","DOIUrl":"10.1016/j.ijrobp.2024.11.085","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page 845"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Radiation Oncologist's Guide to Contouring the Hypothalamus","authors":"R. Brisson,&nbsp;A. Alghamdi,&nbsp;V. Cassidy,&nbsp;D. Indelicato","doi":"10.1016/j.ijrobp.2024.11.024","DOIUrl":"10.1016/j.ijrobp.2024.11.024","url":null,"abstract":"<div><h3>Objectives</h3><div>The hypothalamus is a complex structure involved in maintaining homeostasis in the body. Radiation induces potential hypothalamic damage leading to dysfunction and hormonal endocrinopathies that have vast clinical manifestations and significant long term health complications. Thus, limiting dose to the hypothalamus could have significant implications on treatment morbidity and long-term quality of life; however, Identifying the hypothalamus on CT images is challenging due to its intricate structure and unclear anatomic boundaries. We present a hypothalamus contouring atlas using MR images tailored for radiation oncologists during radiation treatment planning.</div></div><div><h3>Methods</h3><div>Imaging was obtained on a 1.5 Tesla Philips MRI scanner with 3 mm slice thickness using T1 MPRAGE sequences with IV gadolinium. Contouring was completed in MIM Maestro v7.2.3 based on anatomy visible on axial and sagittal images consistent with standard practice for delineating organs at risk.</div></div><div><h3>Results</h3><div>The first step begins with identification of the anterior (AC) and posterior (PC) commissure. Utilize a 5 mm brush to contour the lateral surface of the third ventricle between the AC and PC. Next, continue contouring inferiorly, following the third ventricle anteriorly. The inferior border is defined by the optic chiasm (OC), infundibulum, tuber cinereum, and mammillary bodies (MB). Stop contouring one slice above the level of the OC/MB. Then, assess the posterior margin, defined by an imaginary line connecting the MB to the PC. Finally, assess the anterior margin. To ensure inclusion of the preoptic hypothalamus contours should extend rostrally to an imaginary line between the OC and the AC.</div></div><div><h3>Conclusion</h3><div>Accurately defining the hypothalamus is critical for dosimetric precision, minimizing exposure to radiation, and improved long term outcomes. The presented guide provides a practical approach for contouring the hypothalamus on axial MRI imaging for radiation treatment planning.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e5"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Care and Disparities for Access to Proton Therapy for Pediatric Patients in Alberta (2010-2022)","authors":"D. Bru,&nbsp;M. Mahsin,&nbsp;T. Jarada,&nbsp;W. Cheung,&nbsp;S. Chafe,&nbsp;R. Nordal,&nbsp;S. Patel,&nbsp;N. Logie","doi":"10.1016/j.ijrobp.2024.11.057","DOIUrl":"10.1016/j.ijrobp.2024.11.057","url":null,"abstract":"<div><h3>Objectives</h3><div>Canada is the only G7 nation without a clinical proton therapy (PRT) facility. In 2013, Alberta published guidelines for PRT referral to an out-of-country facility (updated in 2019 and 2023). While the Alberta Ministry of Health covers direct costs of PRT, patients encounter indirect costs. Data from the US National Cancer Database has demonstrated notable socioeconomic (SES) and geographic disparities in the receipt of PRT. This study aimed to analyze trends and disparities in access to PRT in a Canadian province.</div></div><div><h3>Methods</h3><div>Using the Alberta Health Services (AHS) pediatric database, we identified pediatric patients receiving radiotherapy (RT) between 2010-2022 meeting AHS guidelines for PRT. Patient, clinical, and treatment demographics were extracted from electronic medical record. Postal code data at diagnosis provided community characteristics including household income, employment, education, and distance to the nearest photon therapy (PHT) centre. Univariable and multivariable analysis were performed (sig. p&lt;0.05).</div></div><div><h3>Results</h3><div>Two hundred and twenty-eight pediatric patients received definitive RT, of those, 35 (15.4%) received PRT. The median age at diagnosis was 9.6 [1-18] and 59.2% were male. On multivariable analysis, patient age, gender, and household income was not associated with receiving PHT (p&gt;0.9, p=0.4, p=0.6). On multivariable analysis, primary tumor site and distance to the nearest PHT were significantly associated with receiving PRT. Patients with a CNS primary were significantly more likely to receive PRT (OR=8.53, 95% CI=3.44-24.7, p&lt;0.001). Patients living &gt;25km to the nearest PHT centre were also more likely to receive PRT (OR=2.48, 95% CI=1.09-5.91, p=0.034). Over the course of years 2010-2022, the proportion of patients receiving PRT were as follows: 0%, 12%, 13%, 29%, 43%, 9%, 18%, 29%,15%, 37%, 35%, 16%, and 23% (mean=17%).</div></div><div><h3>Conclusion</h3><div>In this cohort of patients, SES disparities were not observed for patients receiving PRT vs PHT. Contrary to other studies, we did not observe an incremental increase in utilization of PRT from 2010-2022 despite guideline revisions. Most patients receiving PRT had CNS tumors and lived &gt;25 km to the nearest PHT centre. As PRT referral is guided by provincial guidelines, further Canadian data is needed.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e16"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Australian Pediatric Brachytherapy Experience: A Pathway to a National Program","authors":"A. Koke ,&nbsp;N. Thiruthaneeswaran ,&nbsp;J. Karpelowsky ,&nbsp;G. Busuttil ,&nbsp;E. Flower ,&nbsp;J. Bucci ,&nbsp;V. Ahern ,&nbsp;E. Sullivan","doi":"10.1016/j.ijrobp.2024.11.043","DOIUrl":"10.1016/j.ijrobp.2024.11.043","url":null,"abstract":"<div><h3>Objectives</h3><div>Pediatric cancers are rare and most children requiring radiation therapy receive external beam radiation (EBRT). Although EBRT may offer organ preservation compared to surgery, it can be associated with significant late effects. Image guided brachytherapy is a highly specialised technique offering both organ preservation and dose conformity to minimise late toxicity. The objective is to report on the set up of the first Australian paediatric brachytherapy service, including patient selection, dosimetric parameters and toxicity outcomes. This includes generating comparative proton plans in cases where imaging was available.</div></div><div><h3>Methods</h3><div>This is a retrospective mono-institutional review of paediatric brachytherapy in one of the largest paediatric centres in Australia. Outcomes and toxicities are presented as well as brachytherapy versus proton plan comparison in four patients.</div></div><div><h3>Results</h3><div>A total of 14 patients were treated with adjuvant brachytherapy between 2012-2022. All patients had pelvic tumours with the predominant histology being rhabdomyosarcoma. High dose rate (HDR) brachytherapy was used for 13 patients with one patient receiving low dose rate (LDR) brachytherapy. Only one grade three late toxicity was reported and two patients developed metastatic disease within one year of completion of treatment. The brachytherapy plan was superior to protons in two of four patients and equivocal in one patient.</div></div><div><h3>Conclusion</h3><div>This retrospective series demonstrates the feasibility and safety of brachytherapy in paediatric pelvic tumours. The initial work presented here demonstrates the value of a comprehensive radiation plan selection for individual paediatric patients.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages e11-e12"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}