International Journal of Radiation Oncology Biology Physics最新文献_第8页

Report of Nine Cases of Embryonal Tumors of the Central Nervous System with Multilayered Rosettes (ETMR)

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.039

R. Ai , J. Li , M. Lai , R. Al

Objective

Embryonal Tumors of the Central Nervous System with Multilayered Rosettes (ETMR) are rare, and there's no standard treatment protocol. This article reports on the current treatment status and prognosis of ETMR in our hospital.

Methods

We retrospectively collected patients with ETMR who received treatment in the Oncology Department of Guangdong sanjiu Brain Hospital from January 2017 to January 2021, analyzed their clinical data.

Results

Among 31 cases of central nervous system embryonic tumors (excluding medulloblastoma and ATRT), 9 (29.03%) were ETMR. The median age at diagnosis was 3 years old (1-15), and the male to female ratio was 4:5. Among them, 5 cases were accompanied by C19MC gene variation. Tumor location:6 was in supratentorial, 1 in the pineal region, 1 in the pons, 1 in the cerebellopontine. Eight patients underwent surgical resection at the first diagnosis, with 6 cases of total resection, 1 case of partial resection, and 1 case of biopsy. One case was misdiagnosed as a germinoma in the pineal region at the initial. After recurrence, surgical resection was performed to confirm the pathology as ETMR. One case was misdiagnosed as glioblastoma during the first surgery. The initial treatment for 4 patients after surgery was radiotherapy combined with concurrent chemotherapy. Recurrence patterns: 2 cases were intracranial dissemination, 2 cases were local recurrence, 1 was spinal cord dissemination. One patient did not receive treatment after surgery and tumor recurrence 3 months later. Survival analysis: The median survival time was 20 months. The 1-year progression-free survival rate (PFS) and overall survival rate (OS) were 22% and 61%, and the 2-year overall survival rate (OS) was 31%.

Conclusion

ETMR has a low incidence and poor prognosis. It is easy to misdiagnose and NGS is necessary to assist diagnosis when needed. More effective treatment methods need to be explored.

{"title":"Report of Nine Cases of Embryonal Tumors of the Central Nervous System with Multilayered Rosettes (ETMR)","authors":"R. Ai , J. Li , M. Lai , R. Al","doi":"10.1016/j.ijrobp.2024.11.039","DOIUrl":"10.1016/j.ijrobp.2024.11.039","url":null,"abstract":"<div><h3>Objective</h3><div>Embryonal Tumors of the Central Nervous System with Multilayered Rosettes (ETMR) are rare, and there's no standard treatment protocol. This article reports on the current treatment status and prognosis of ETMR in our hospital.</div></div><div><h3>Methods</h3><div>We retrospectively collected patients with ETMR who received treatment in the Oncology Department of Guangdong sanjiu Brain Hospital from January 2017 to January 2021, analyzed their clinical data.</div></div><div><h3>Results</h3><div>Among 31 cases of central nervous system embryonic tumors (excluding medulloblastoma and ATRT), 9 (29.03%) were ETMR. The median age at diagnosis was 3 years old (1-15), and the male to female ratio was 4:5. Among them, 5 cases were accompanied by C19MC gene variation. Tumor location:6 was in supratentorial, 1 in the pineal region, 1 in the pons, 1 in the cerebellopontine. Eight patients underwent surgical resection at the first diagnosis, with 6 cases of total resection, 1 case of partial resection, and 1 case of biopsy. One case was misdiagnosed as a germinoma in the pineal region at the initial. After recurrence, surgical resection was performed to confirm the pathology as ETMR. One case was misdiagnosed as glioblastoma during the first surgery. The initial treatment for 4 patients after surgery was radiotherapy combined with concurrent chemotherapy. Recurrence patterns: 2 cases were intracranial dissemination, 2 cases were local recurrence, 1 was spinal cord dissemination. One patient did not receive treatment after surgery and tumor recurrence 3 months later. Survival analysis: The median survival time was 20 months. The 1-year progression-free survival rate (PFS) and overall survival rate (OS) were 22% and 61%, and the 2-year overall survival rate (OS) was 31%.</div></div><div><h3>Conclusion</h3><div>ETMR has a low incidence and poor prognosis. It is easy to misdiagnose and NGS is necessary to assist diagnosis when needed. More effective treatment methods need to be explored.</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":"143102885","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}

引用次数: 0

Establishing the Australian Particle Therapy Clinical Quality Registry - ASPIRE

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.045

K. Skelton , F. Saran , P. Gorayski , H. Le

Objectives

The Australian Bragg Centre for Proton Therapy and Research (ABCPTR), a wholly owned subsidiary of the South Australian Health and Medical Research Institute (SAHMRI) secured Medicare Benefits Schedule (MBS) listings for cancers treatable with Proton Beam Therapy (PBT). Addressing the complexities of cost-utility for PBT, the Medical Services Advisory Committee advocated for a national registry to affirm PBT's safety benefits over Photon Radiation Therapy (PRT). This registry aims to validate health economic analyses for the MBS submission and support evidence for future applications, enhancing PBT's role in cancer treatment.

Methods

In alignment with MBS application goals, the Australian Particle Therapy Clinical Quality Registry (ASPIRE) was initiated in 2022. Currently, two sites are actively recruiting, with four more in different stages of approval nationwide. ASPIRE, a forward-looking, observational study, focuses on paediatric, adolescent, and rare adult cancer cases within specified tumour categories receiving radiation therapy. It aims to examine treatment patterns and gather long-term data on outcomes for patients treated with PRT or PBT.

Results

The ABCPTR is set to establish a crucial PBT service for the regions of Australia and New Zealand. Predictive modelling for the ABCPTR suggests that - using current MBS refundable indications for PBT - 80% of treated patients will be under 25 years of age.

Conclusion

ASPIRE will standardize radiation oncology data collection, capturing key patient data, short- and long-term toxicities, and outcomes for MBS-funded radiation treatments. This data, accessible to Australian researchers, will provide unique clinical and cost utility insights not available in other national registries.

{"title":"Establishing the Australian Particle Therapy Clinical Quality Registry - ASPIRE","authors":"K. Skelton , F. Saran , P. Gorayski , H. Le","doi":"10.1016/j.ijrobp.2024.11.045","DOIUrl":"10.1016/j.ijrobp.2024.11.045","url":null,"abstract":"<div><h3>Objectives</h3><div>The Australian Bragg Centre for Proton Therapy and Research (ABCPTR), a wholly owned subsidiary of the South Australian Health and Medical Research Institute (SAHMRI) secured Medicare Benefits Schedule (MBS) listings for cancers treatable with Proton Beam Therapy (PBT). Addressing the complexities of cost-utility for PBT, the Medical Services Advisory Committee advocated for a national registry to affirm PBT's safety benefits over Photon Radiation Therapy (PRT). This registry aims to validate health economic analyses for the MBS submission and support evidence for future applications, enhancing PBT's role in cancer treatment.</div></div><div><h3>Methods</h3><div>In alignment with MBS application goals, the Australian Particle Therapy Clinical Quality Registry (ASPIRE) was initiated in 2022. Currently, two sites are actively recruiting, with four more in different stages of approval nationwide. ASPIRE, a forward-looking, observational study, focuses on paediatric, adolescent, and rare adult cancer cases within specified tumour categories receiving radiation therapy. It aims to examine treatment patterns and gather long-term data on outcomes for patients treated with PRT or PBT.</div></div><div><h3>Results</h3><div>The ABCPTR is set to establish a crucial PBT service for the regions of Australia and New Zealand. Predictive modelling for the ABCPTR suggests that - using current MBS refundable indications for PBT - 80% of treated patients will be under 25 years of age.</div></div><div><h3>Conclusion</h3><div>ASPIRE will standardize radiation oncology data collection, capturing key patient data, short- and long-term toxicities, and outcomes for MBS-funded radiation treatments. This data, accessible to Australian researchers, will provide unique clinical and cost utility insights not available in other national registries.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e12"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102890","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}

引用次数: 0

Standardization of Immobilization for Reproducible Set-Up for Patients Under 18 Years Treated with Proton Beam Therapy in the Thoracic Region

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.052

T. Patel , K. Osbourn , C. Dunlea , K. Quingua , S. Petkar , E. Patel , W. Harrison-Carey , H. Grimes , J. Gains , P. Lim

Objectives

To review positioning and immobilisation for patients treated with PBT in the thoracic region for sarcoma and lymphoma. To evaluate daily set up error from imaging data, comparing immobilisation methods.

Methods

A retrospective analysis of patients ≤18 years treated with PBT in the thoracic region at University College London Hospitals from December 2021 to present date was undertaken. Diagnosis, age, general anaesthetic requirement, treatment site, positioning and immobilisation were recorded. Image verification data including daily set up error, additional imaging and dosimetric evaluation of positional discrepancies were captured and analysed from ARIA record and verify system.

Results

Twenty patients, with a mean range of age of 13 years (range 5-18y), were treated. Five patients were treated under general anaesthesia. All patients were immobilised in either a long vacuum bag, short vacuum bag or head and shoulders thermoplastic shell with personalised Moldcare® cushion. Individual and population set up error means and standard deviation were calculated and compared by immobilisation type, general anaesthesia status and treatment site. Due to small population, no statistically significant differences in set-up errors were noted for all variables. Overall population translation means ≤1mm, standard deviation ≤0.3; rotational means ≤0.2°, standard deviation ≤0.75. Shoulder position was the most frequent cause for patient re-positioning, followed by correction of yaw. Patients immobilised in head and shoulders thermoplastic shells did not show reduced set-up error compared to those immobilised in a vacuum bag. This was attributed to patient specific factors. Patients ≥10 years treated under general anaesthesia had greater set-up error than those treated awake.

Conclusion

The optimal immobilisation method is determined primarily by treatment site and beam arrangement for treatment delivery. Patient factors such as comfort and compliance influenced set-up reproducibility and should be given due consideration, when selecting immobilisation, in all cases.

{"title":"Standardization of Immobilization for Reproducible Set-Up for Patients Under 18 Years Treated with Proton Beam Therapy in the Thoracic Region","authors":"T. Patel , K. Osbourn , C. Dunlea , K. Quingua , S. Petkar , E. Patel , W. Harrison-Carey , H. Grimes , J. Gains , P. Lim","doi":"10.1016/j.ijrobp.2024.11.052","DOIUrl":"10.1016/j.ijrobp.2024.11.052","url":null,"abstract":"<div><h3>Objectives</h3><div>To review positioning and immobilisation for patients treated with PBT in the thoracic region for sarcoma and lymphoma. To evaluate daily set up error from imaging data, comparing immobilisation methods.</div></div><div><h3>Methods</h3><div>A retrospective analysis of patients ≤18 years treated with PBT in the thoracic region at University College London Hospitals from December 2021 to present date was undertaken. Diagnosis, age, general anaesthetic requirement, treatment site, positioning and immobilisation were recorded. Image verification data including daily set up error, additional imaging and dosimetric evaluation of positional discrepancies were captured and analysed from ARIA record and verify system.</div></div><div><h3>Results</h3><div>Twenty patients, with a mean range of age of 13 years (range 5-18y), were treated. Five patients were treated under general anaesthesia. All patients were immobilised in either a long vacuum bag, short vacuum bag or head and shoulders thermoplastic shell with personalised Moldcare® cushion. Individual and population set up error means and standard deviation were calculated and compared by immobilisation type, general anaesthesia status and treatment site. Due to small population, no statistically significant differences in set-up errors were noted for all variables. Overall population translation means ≤1mm, standard deviation ≤0.3; rotational means ≤0.2°, standard deviation ≤0.75. Shoulder position was the most frequent cause for patient re-positioning, followed by correction of yaw. Patients immobilised in head and shoulders thermoplastic shells did not show reduced set-up error compared to those immobilised in a vacuum bag. This was attributed to patient specific factors. Patients ≥10 years treated under general anaesthesia had greater set-up error than those treated awake.</div></div><div><h3>Conclusion</h3><div>The optimal immobilisation method is determined primarily by treatment site and beam arrangement for treatment delivery. Patient factors such as comfort and compliance influenced set-up reproducibility and should be given due consideration, when selecting immobilisation, in all cases.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e14"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103351","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}

引用次数: 0

Outcomes of Patients Managed for Wilms’ Tumor at Kenyatta National Hospital, Nairobi Kenya

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.032

A. Rugwe

Objectives

Wilms' Tumor is a highly curable malignancy with excellent 5 year survival rates of >90% in the developed countries however, the developing countries continue to record dismal survival rates. This is due to late presentations, treatment abandonment and poor healthcare infrastructure .Over time, the developing countries have had better healthcare systems in terms of better imaging and diagnostics, better surgical skills, better access to care and infrastructure.

This study intended to assess the outcomes of patients managed at Kenyatta National Hospital, Kenya post these advancements

Methods

This was retrospective cross-sectional study of 51 patients with Wilms' Tumor diagnosed and treated 1st January 2015 to 31st December 2019 at Kenyatta National Hospital, Kenya. Inclusion criteria: all patients between 0-16 years with Wilms' Tumor. Exclusion criteria: none.

Data analysis was performed using STATA 11.0 and Kaplan Meier was used to determine the 2 year survival rate

Results

The mean age at diagnosis was 4.1.Male and female had an equal distribution. Most common presenting symptom was abdominal distention (which is usually associated with advanced disease).Most common imaging modality used to stage; Abdomen was CT scan and for chest imaging was a chest X-ray .Most patients had favorable histology. SIOP treatment protocol is the most common treatment protocol used.

Most patients presented with stage III disease(which is an advanced stage) and 98% of the patients studied were alive at 2 years post treatment .

Conclusion

Patients are still presenting with late stage disease however our survival rates have greatly improved and is approaching that of the developed countries. SIOP protocol has been adopted by most developing countries.

{"title":"Outcomes of Patients Managed for Wilms’ Tumor at Kenyatta National Hospital, Nairobi Kenya","authors":"A. Rugwe","doi":"10.1016/j.ijrobp.2024.11.032","DOIUrl":"10.1016/j.ijrobp.2024.11.032","url":null,"abstract":"<div><h3>Objectives</h3><div>Wilms' Tumor is a highly curable malignancy with excellent 5 year survival rates of >90% in the developed countries however, the developing countries continue to record dismal survival rates. This is due to late presentations, treatment abandonment and poor healthcare infrastructure .Over time, the developing countries have had better healthcare systems in terms of better imaging and diagnostics, better surgical skills, better access to care and infrastructure.</div><div>This study intended to assess the outcomes of patients managed at Kenyatta National Hospital, Kenya post these advancements</div></div><div><h3>Methods</h3><div>This was retrospective cross-sectional study of 51 patients with Wilms' Tumor diagnosed and treated 1st January 2015 to 31st December 2019 at Kenyatta National Hospital, Kenya. Inclusion criteria: all patients between 0-16 years with Wilms' Tumor. Exclusion criteria: none.</div><div>Data analysis was performed using STATA 11.0 and Kaplan Meier was used to determine the 2 year survival rate</div></div><div><h3>Results</h3><div>The mean age at diagnosis was 4.1.Male and female had an equal distribution. Most common presenting symptom was abdominal distention (which is usually associated with advanced disease).Most common imaging modality used to stage; Abdomen was CT scan and for chest imaging was a chest X-ray .Most patients had favorable histology. SIOP treatment protocol is the most common treatment protocol used.</div><div>Most patients presented with stage III disease(which is an advanced stage) and 98% of the patients studied were alive at 2 years post treatment .</div></div><div><h3>Conclusion</h3><div>Patients are still presenting with late stage disease however our survival rates have greatly improved and is approaching that of the developed countries. SIOP protocol has been adopted by most developing countries.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e8"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103479","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}

引用次数: 0

Unilateral Retinoblastoma: Audit of Outcomes of Children treated with Curative Treatment Protocol

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.035

N. Khanna , Y. Rathod , J. Manjali , B. Parambil , G. Chinnaswamy , M. Prasad , R. Gollamudi , V. Patil , A. Baheti , K. Gala , S. Shah , P. Panjwani , M. Ramadwar , N. Shetye , S. Qureshi , S. Laskar

Objectives

To evaluate treatment outcome of children diagnosed with unilateral retinoblastoma.

Methods

Retrospective study of children diagnosed with unilateral retinoblastoma registered at our institute from January 2013 to December 2018 and completed the curative treatment protocol.

Results

For the 98 cases analyzed the median age was 24 months. At the time of presentation, 72 had intraocular and 26 had orbital. On imaging extra-scleral spread was observed in 16 patients whereas 18 patients had optic nerve (ON) involvement, 11 patients had both extra-scleral invasion and ON involvement. Majority we ICRB group E (71), and group D=21, group C= 2, group B=4. Majority were IRSS Stage 1(stage0=14, stage1=52, stage2=10, stage3a=21 and stage3b=1). High-risk features on surgical specimen histopathology were ON margin positivity in 6, ON involvement in 21, extra-scleral spread in 3, choroidal invasion in 38 and iris involvement in 10 patients.

Eneucleation was offered to 78 (Primary=52, secondary=26). Chemotherapy was offered to 68 (chemoreduction=17, adjuvant chemotherapy=51). Intra-arterial chemotherapy was offered to 27 patients as a primary treatment or in conjugation with focal therapy (n=11). Definitive radiotherapy was offered to only 2 patients and 22 patients received adjuvant radiotherapy.

At a median follow-up of 62 months, 2 patients had local relapse, which was salvaged by focal therapy in one and enucleation in the other. Ten patients who had leptomeningeal relapse had died. The 5-year local control (LC) is 97.6%, event-free survival (EFS) is 88% and overall survival (OS) is 89.5%. Globe was salvaged in only 16 cases. On univariate analysis, orbital disease, extra-scleral spread, ON involvement (imaging), and ON margin positivity, higher ICRB Group and IRSS stage had poor impact on OS.

Conclusion

Retinoblastoma is curable with optimal globe salvage rates if detected early. Orbital disease, high risk features on surgical specimen histopathology and leptomeningeal relapse are associated with inferior outcomes.

{"title":"Unilateral Retinoblastoma: Audit of Outcomes of Children treated with Curative Treatment Protocol","authors":"N. Khanna , Y. Rathod , J. Manjali , B. Parambil , G. Chinnaswamy , M. Prasad , R. Gollamudi , V. Patil , A. Baheti , K. Gala , S. Shah , P. Panjwani , M. Ramadwar , N. Shetye , S. Qureshi , S. Laskar","doi":"10.1016/j.ijrobp.2024.11.035","DOIUrl":"10.1016/j.ijrobp.2024.11.035","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate treatment outcome of children diagnosed with unilateral retinoblastoma.</div></div><div><h3>Methods</h3><div>Retrospective study of children diagnosed with unilateral retinoblastoma registered at our institute from January 2013 to December 2018 and completed the curative treatment protocol.</div></div><div><h3>Results</h3><div>For the 98 cases analyzed the median age was 24 months. At the time of presentation, 72 had intraocular and 26 had orbital. On imaging extra-scleral spread was observed in 16 patients whereas 18 patients had optic nerve (ON) involvement, 11 patients had both extra-scleral invasion and ON involvement. Majority we ICRB group E (71), and group D=21, group C= 2, group B=4. Majority were IRSS Stage 1(stage0=14, stage1=52, stage2=10, stage3a=21 and stage3b=1). High-risk features on surgical specimen histopathology were ON margin positivity in 6, ON involvement in 21, extra-scleral spread in 3, choroidal invasion in 38 and iris involvement in 10 patients.</div><div>Eneucleation was offered to 78 (Primary=52, secondary=26). Chemotherapy was offered to 68 (chemoreduction=17, adjuvant chemotherapy=51). Intra-arterial chemotherapy was offered to 27 patients as a primary treatment or in conjugation with focal therapy (n=11). Definitive radiotherapy was offered to only 2 patients and 22 patients received adjuvant radiotherapy.</div><div>At a median follow-up of 62 months, 2 patients had local relapse, which was salvaged by focal therapy in one and enucleation in the other. Ten patients who had leptomeningeal relapse had died. The 5-year local control (LC) is 97.6%, event-free survival (EFS) is 88% and overall survival (OS) is 89.5%. Globe was salvaged in only 16 cases. On univariate analysis, orbital disease, extra-scleral spread, ON involvement (imaging), and ON margin positivity, higher ICRB Group and IRSS stage had poor impact on OS.</div></div><div><h3>Conclusion</h3><div>Retinoblastoma is curable with optimal globe salvage rates if detected early. Orbital disease, high risk features on surgical specimen histopathology and leptomeningeal relapse are associated with inferior outcomes.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e9"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103482","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}

引用次数: 0

Clinical Outcomes of Radiation Therapy for Brain Stem Glioma

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.059

K. Pyone , T. Tun , L. Myint , T. Hnin , A. Khaing

Objectives

Brain Stem Gliomas are up to 20% of all brain tumors in children and unusual in adults. Radiotherapy is mainstay of treatment. Surgery for brain stem glioma is difficult because of anatomical location. This study was performed to evaluate the clinical outcomes of radiotherapy in brain stem glioma.

Methods

Retrospective analysis of brain stem glioma patients treated with radiation therapy (54 Gy/ 30 fractions of IMRT or 3D CRT) with or without surgery or chemotherapy or other agents in Yangon General Hospital, Myanmar.

Results

Twenty-four patients (median age 11.8 years) were treated between 2016 and 2020. Male to female ratio was 2:3. Surgical approach (Biopsy and partial removal) was done in 16 patients. Histology revealed that anaplastic ependymoma in 2 patients, low-grade astrocytoma in 2 patients, anaplastic astrocytoma in 8 patients, glioblastoma in 4 patients and remaining 8 patients had no histological diagnosis. Radiotherapy (dose-54Gy/ 30 fractions) was given with the technique of IMRT or 3D CRT. At the time of follow-up, 8 patients had local recurrence, 10 patients died of due to disease and recurrence, 14 patients were alive. Among alive patients, 2 patients were treated with chemotherapy and 12 patients with temozolomide for 12 cycles. Patients who received temozolomide got improvement in performance status and reduced clinical symptoms; among them, 6 patients had more than 50% objective tumor response in radiological findings for follow-up 3-6 months after radiotherapy. The 3-years overall survival (OS) rate was 58.3% and 3 years Event-free Survival (EFS) rate was 50%. The medium survival time was 14 months. There is no Grade 3 or greater acute and late toxicities.

Conclusion

As the LMIC country with limited resources, our results of radiotherapy followed by temozolomide in brain stem gliomas have optimal outcomes. However, prospective studies of this select group of patients with larger number and longer follow-up is required.

{"title":"Clinical Outcomes of Radiation Therapy for Brain Stem Glioma","authors":"K. Pyone , T. Tun , L. Myint , T. Hnin , A. Khaing","doi":"10.1016/j.ijrobp.2024.11.059","DOIUrl":"10.1016/j.ijrobp.2024.11.059","url":null,"abstract":"<div><h3>Objectives</h3><div>Brain Stem Gliomas are up to 20% of all brain tumors in children and unusual in adults. Radiotherapy is mainstay of treatment. Surgery for brain stem glioma is difficult because of anatomical location. This study was performed to evaluate the clinical outcomes of radiotherapy in brain stem glioma.</div></div><div><h3>Methods</h3><div>Retrospective analysis of brain stem glioma patients treated with radiation therapy (54 Gy/ 30 fractions of IMRT or 3D CRT) with or without surgery or chemotherapy or other agents in Yangon General Hospital, Myanmar.</div></div><div><h3>Results</h3><div>Twenty-four patients (median age 11.8 years) were treated between 2016 and 2020. Male to female ratio was 2:3. Surgical approach (Biopsy and partial removal) was done in 16 patients. Histology revealed that anaplastic ependymoma in 2 patients, low-grade astrocytoma in 2 patients, anaplastic astrocytoma in 8 patients, glioblastoma in 4 patients and remaining 8 patients had no histological diagnosis. Radiotherapy (dose-54Gy/ 30 fractions) was given with the technique of IMRT or 3D CRT. At the time of follow-up, 8 patients had local recurrence, 10 patients died of due to disease and recurrence, 14 patients were alive. Among alive patients, 2 patients were treated with chemotherapy and 12 patients with temozolomide for 12 cycles. Patients who received temozolomide got improvement in performance status and reduced clinical symptoms; among them, 6 patients had more than 50% objective tumor response in radiological findings for follow-up 3-6 months after radiotherapy. The 3-years overall survival (OS) rate was 58.3% and 3 years Event-free Survival (EFS) rate was 50%. The medium survival time was 14 months. There is no Grade 3 or greater acute and late toxicities.</div></div><div><h3>Conclusion</h3><div>As the LMIC country with limited resources, our results of radiotherapy followed by temozolomide in brain stem gliomas have optimal outcomes. However, prospective studies of this select group of patients with larger number and longer follow-up is required.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages e16-e17"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099111","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}

引用次数: 0

Proton Radiation in Children with Thoracic Ewing Sarcoma: Results of the Prospective KiProReg Registry

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.037

T. Steinmeiner , C. Hansel , D. Ahmad Khalil , S. Plaude , S. Scobioala , C. Blase , S. Tippelt , S. Bauer , U. Dirksen , R. Kortmann , B. Timmermann

Objectives

Proton therapy (PT) is increasingly used for the treatment of thoracic Ewing sarcoma (EwS), aiming to reduce radiotherapy-related side effects. We examined pediatric patients with thoracic EwS treated with PT.

Methods

Children with localized thoracic EwS participating in the internal KiProReg registry treated at our institution between 2014 and 2023 were included. Data on patients, tumor, treatment and side effects (acc. to CTCAEv4/5) was analyzed.

Results

Twenty-eight children (14m, 14f) with a median age of 11.4 years (range 1.9-17.1) were included. Twenty-seven children received chemotherapy before and 16 concomitant to PT. Treatment concepts were adjuvant/definitive/neoadjuvant in 68%/21%/11%, respectively. Complete resection was achieved in 14 children. All children were treated locally on the primary tumor or local recurrence. Median total dose was 50.4 Gy (range 45.0-59.4 Gy). Median follow-up time after initial diagnosis was 37.5 months (range 6.6-113.3 months). Local tumor control was achieved in 25 patients (89.3%), three patients developed dissemination. In total, three patients deceased. Early higher-grade (>grade2) side-effects during PT occurred in 19 patients, predominantly on skin (n=5) and/or blood/lymphatic system (n=16). One patient developed a late fracture in the irradiated area. Among patients with ≥ 1 year FU after PT (n=20), no high-grade late cardiac/pulmonary toxicities have been observed to date.

Conclusion

PT was well tolerated in this challenging sample. Local control was achieved in the majority of patients. These results need to be confirmed with longer follow-up and in larger cohorts.

{"title":"Proton Radiation in Children with Thoracic Ewing Sarcoma: Results of the Prospective KiProReg Registry","authors":"T. Steinmeiner , C. Hansel , D. Ahmad Khalil , S. Plaude , S. Scobioala , C. Blase , S. Tippelt , S. Bauer , U. Dirksen , R. Kortmann , B. Timmermann","doi":"10.1016/j.ijrobp.2024.11.037","DOIUrl":"10.1016/j.ijrobp.2024.11.037","url":null,"abstract":"<div><h3>Objectives</h3><div>Proton therapy (PT) is increasingly used for the treatment of thoracic Ewing sarcoma (EwS), aiming to reduce radiotherapy-related side effects. We examined pediatric patients with thoracic EwS treated with PT.</div></div><div><h3>Methods</h3><div>Children with localized thoracic EwS participating in the internal KiProReg registry treated at our institution between 2014 and 2023 were included. Data on patients, tumor, treatment and side effects (acc. to CTCAEv4/5) was analyzed.</div></div><div><h3>Results</h3><div>Twenty-eight children (14m, 14f) with a median age of 11.4 years (range 1.9-17.1) were included. Twenty-seven children received chemotherapy before and 16 concomitant to PT. Treatment concepts were adjuvant/definitive/neoadjuvant in 68%/21%/11%, respectively. Complete resection was achieved in 14 children. All children were treated locally on the primary tumor or local recurrence. Median total dose was 50.4 Gy (range 45.0-59.4 Gy). Median follow-up time after initial diagnosis was 37.5 months (range 6.6-113.3 months). Local tumor control was achieved in 25 patients (89.3%), three patients developed dissemination. In total, three patients deceased. Early higher-grade (>grade2) side-effects during PT occurred in 19 patients, predominantly on skin (n=5) and/or blood/lymphatic system (n=16). One patient developed a late fracture in the irradiated area. Among patients with ≥ 1 year FU after PT (n=20), no high-grade late cardiac/pulmonary toxicities have been observed to date.</div></div><div><h3>Conclusion</h3><div>PT was well tolerated in this challenging sample. Local control was achieved in the majority of patients. These results need to be confirmed with longer follow-up and in larger cohorts.</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":"143102884","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}

引用次数: 0

PP-30 Cumulative Incidence Rate of Radiation-Induced Hearing Loss after Radiotherapy in Pediatric Brain Tumor

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.062

P. Poolsawatkitikool , C. Nantavithya , K. Shotelersuk , N. Utoomprurkporn

Objectives

This retrospective cohort study aims to report the cumulative incidence of RIHL, associated risk factors, and develope normal tissue complication probability (NTCP) models for predicting hearing loss (HL) in Thai children with brain tumors receiving radiotherapy.

Methods

Data of pediatric brain tumor patients who received radiotherapy session at King Chulalongkorn Memorial Hospital were collected. Audiometric assessments were performed at and/or after 6 months post-radiotherapy. Cumulative incidences of any grade of HL and deleterious hearing loss (≥ grade 2 HL, DHL) were calculated based on demographics and treatments, including patients have received not only radiotherapy, but also chemotherapy and/or surgery. Logistic regression, NTCP models, and statistical analyses were employed to evaluate factors influencing ototoxicity.

Results

Data from 56 eligible participants who underwent radiotherapy between January 2017 and June 2023 were included in our study. With a median follow-up time of 3.4 years, the cumulative incidence of ≥ grade 1 and ≥ grade 2 of hearing loss were 41.1%, and 37.4%, respectively. Predictive factors of RIHL included infratentorial location, mean dose (Dmean) of cochlea, and/or internal acoustic canal (IAC). We provided two NTCP models, incorporating Dmean of auditory organs and location of tumor in the formula. The first model predicted the probability of HL and DHL by calculation from Dmean of cochlea. Whereas the second model used the cut-off level of Dmean to cochlea and IAC, 32 and 37 Gy, respectively to prevent HL. Both models demonstrated good performance.

Conclusion

Over a third of pediatric brain tumor patients who underwent radiotherapy developed DHL. Dmean of cochlea and IAC, and location of tumor were associated with both HL and DHL. Our findings recommends limiting Dmean of cochlea and IAC below 32 and 37 Gy, respectively, to reduce HL and DHL.

{"title":"PP-30 Cumulative Incidence Rate of Radiation-Induced Hearing Loss after Radiotherapy in Pediatric Brain Tumor","authors":"P. Poolsawatkitikool , C. Nantavithya , K. Shotelersuk , N. Utoomprurkporn","doi":"10.1016/j.ijrobp.2024.11.062","DOIUrl":"10.1016/j.ijrobp.2024.11.062","url":null,"abstract":"<div><h3>Objectives</h3><div>This retrospective cohort study aims to report the cumulative incidence of RIHL, associated risk factors, and develope normal tissue complication probability (NTCP) models for predicting hearing loss (HL) in Thai children with brain tumors receiving radiotherapy.</div></div><div><h3>Methods</h3><div>Data of pediatric brain tumor patients who received radiotherapy session at King Chulalongkorn Memorial Hospital were collected. Audiometric assessments were performed at and/or after 6 months post-radiotherapy. Cumulative incidences of any grade of HL and deleterious hearing loss (≥ grade 2 HL, DHL) were calculated based on demographics and treatments, including patients have received not only radiotherapy, but also chemotherapy and/or surgery. Logistic regression, NTCP models, and statistical analyses were employed to evaluate factors influencing ototoxicity.</div></div><div><h3>Results</h3><div>Data from 56 eligible participants who underwent radiotherapy between January 2017 and June 2023 were included in our study. With a median follow-up time of 3.4 years, the cumulative incidence of ≥ grade 1 and ≥ grade 2 of hearing loss were 41.1%, and 37.4%, respectively. Predictive factors of RIHL included infratentorial location, mean dose (Dmean) of cochlea, and/or internal acoustic canal (IAC). We provided two NTCP models, incorporating Dmean of auditory organs and location of tumor in the formula. The first model predicted the probability of HL and DHL by calculation from Dmean of cochlea. Whereas the second model used the cut-off level of Dmean to cochlea and IAC, 32 and 37 Gy, respectively to prevent HL. Both models demonstrated good performance.</div></div><div><h3>Conclusion</h3><div>Over a third of pediatric brain tumor patients who underwent radiotherapy developed DHL. Dmean of cochlea and IAC, and location of tumor were associated with both HL and DHL. Our findings recommends limiting Dmean of cochlea and IAC below 32 and 37 Gy, respectively, to reduce HL and DHL.</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":"143172131","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}

引用次数: 0

Evaluating Potential Dosimetric Advantage of Integrating Highly Conformal Target Delineation with VMAT Compared to Conventional Flank Irradiation for Wilms Tumors

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.050

T. Ali , M. Khan , M. Umer , M. Tariq , B. Qureshi

Objectives

Conventionally flank irradiation for Wilms tumor typically utilized anteroposterior (AP-PA) photon beams. However, recent publications prioritize precise flank target volume delineation following SIOP Renal Tumor Study Group (RTSG) consensus protocol taking postoperative organ shifts and intrafractional motion into consideration. This study aims to evaluate the dosimetric advantage of Volumetric Modulated Arc Therapy (VMAT) versus conventional AP/PA technique for Wilms tumor.

Method

Patients with stage II and III High-risk Wilms tumors referred for postoperative radiotherapy were included. Dosimetric analysis was conducted retrospectively on eight cases. For each patient, separate target volumes were delineated for highly conformal and conventional treatment plans, employing VMAT for highly conformal and AP/PA for conventional volumes. All cases were planned preceding mandatory peer review. A dose of 2520cGy/14fraction was prescribed as per SIOP High-Risk Wilms tumor protocol. Planning target volume (PTV) in cm3, mean doses to the liver, small bowel, contralateral kidney, and spleen were calculated and subsequently compared.

Results

Five (n=10) right-sided and three(n=6) left-sided flank volumes were included. In the study, highly conformal volumes planned via VMAT demonstrated a reduction in PTV compared to conventional volumes, 629.04 cm³ vs. 798.8 cm³ respectively. Mean dose reduction favoring highly conformal target volumes was observed for mean of all OARs, including liver (942.5 cGy conformal vs. 1264 cGy conventional), contralateral kidney (258.6 cGy conformal vs. 294.2 cGy conventional), small bowel (1114.7 cGy conformal vs. 1411.7 cGy conventional), and spleen (1401cGy conformal vs. 1990cGy conventional). VMAT provided greater dose sparing to normal structures as compared to AP/PA techniques.

Conclusion

Compared to conventional AP/PA photon beams, flank irradiation, employing highly conformal flank target volumes with VMAT resulted in reduced doses to the OARs, while still maintaining acceptable organ doses in the AP/PA plan highlighting the value of peer review in ensuring radiation quality, and dosimetric benefits.

{"title":"Evaluating Potential Dosimetric Advantage of Integrating Highly Conformal Target Delineation with VMAT Compared to Conventional Flank Irradiation for Wilms Tumors","authors":"T. Ali , M. Khan , M. Umer , M. Tariq , B. Qureshi","doi":"10.1016/j.ijrobp.2024.11.050","DOIUrl":"10.1016/j.ijrobp.2024.11.050","url":null,"abstract":"<div><h3>Objectives</h3><div>Conventionally flank irradiation for Wilms tumor typically utilized anteroposterior (AP-PA) photon beams. However, recent publications prioritize precise flank target volume delineation following SIOP Renal Tumor Study Group (RTSG) consensus protocol taking postoperative organ shifts and intrafractional motion into consideration. This study aims to evaluate the dosimetric advantage of Volumetric Modulated Arc Therapy (VMAT) versus conventional AP/PA technique for Wilms tumor.</div></div><div><h3>Method</h3><div>Patients with stage II and III High-risk Wilms tumors referred for postoperative radiotherapy were included. Dosimetric analysis was conducted retrospectively on eight cases. For each patient, separate target volumes were delineated for highly conformal and conventional treatment plans, employing VMAT for highly conformal and AP/PA for conventional volumes. All cases were planned preceding mandatory peer review. A dose of 2520cGy/14fraction was prescribed as per SIOP High-Risk Wilms tumor protocol. Planning target volume (PTV) in cm3, mean doses to the liver, small bowel, contralateral kidney, and spleen were calculated and subsequently compared.</div></div><div><h3>Results</h3><div>Five (n=10) right-sided and three(n=6) left-sided flank volumes were included. In the study, highly conformal volumes planned via VMAT demonstrated a reduction in PTV compared to conventional volumes, 629.04 cm³ vs. 798.8 cm³ respectively. Mean dose reduction favoring highly conformal target volumes was observed for mean of all OARs, including liver (942.5 cGy conformal vs. 1264 cGy conventional), contralateral kidney (258.6 cGy conformal vs. 294.2 cGy conventional), small bowel (1114.7 cGy conformal vs. 1411.7 cGy conventional), and spleen (1401cGy conformal vs. 1990cGy conventional). VMAT provided greater dose sparing to normal structures as compared to AP/PA techniques.</div></div><div><h3>Conclusion</h3><div>Compared to conventional AP/PA photon beams, flank irradiation, employing highly conformal flank target volumes with VMAT resulted in reduced doses to the OARs, while still maintaining acceptable organ doses in the AP/PA plan highlighting the value of peer review in ensuring radiation quality, and dosimetric benefits.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e14"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172137","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}

引用次数: 0

Long-term Outcomes Following Proton Therapy for Pediatric Low-grade Glioma of the Spine (LGGS)

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.023

R. Brisson , D. Indellicato , J. Bradley , P. Aldana , D. Klawinski , C. Morris , R. Mailhot

Objectives

Due to its rarity, no standard treatment guidelines exist for LGGS. Proton therapy (PT) offers an attractive modality to minimize toxicity. To date no clinical outcomes on PT in LGGS have been reported. Herein, we present a series of pediatric patients who received PT for progressive LGGS.

Methods

We identified 8 consecutive patients with non-metastatic LGGS treated with PT between 2012 and 2022. We utilized the cumulative incidence method to estimate local control (LC), freedom from distant metastases (FFDM), freedom from progression (FFP), and overall survival (OS). Treatment related toxicity was assessed according to the CTCAEv5.

Results

The median age at diagnosis was 4 years. All patients underwent attempted resection. Pilocytic astrocytoma was the most common tumor histology (n=4). All patients developed recurrence/progression of disease prior to referral for PT, with 3 having ≥ 2 recurrences prior to referral. The median duration between initial surgery and PT was 4.4 years. The median age at the start of PT was 8 years. Most patients (n=5) received PT as ≥ third line treatment. Seven patients were treated with PT to the primary tumor. Most patients (n=7) received between 45-50.4 CGE. Median follow up was 7.8 years. The 10-year KM estimates for LC, FFDM, FFP, and OS were 85%, 88%, 73%, and 55% respectively. One patient experienced malignant transformation and 2 developed pseudoprogression following PT. No pulmonary, gastrointestinal, or musculoskeletal toxicity was observed during or after PT. No patients had ≥ grade 3 radiation related adverse events.

Conclusions

Despite negative selection bias, with many patients having multiple recurrences prior to referral for PT, our experience suggests PT for pediatric LGGS offers long-term disease control with limited acute and late side effects. The favorable therapeutic ratio of PT suggests it should be considered among first-line therapy in children with non-metastatic, unresectable LGGS.

{"title":"Long-term Outcomes Following Proton Therapy for Pediatric Low-grade Glioma of the Spine (LGGS)","authors":"R. Brisson , D. Indellicato , J. Bradley , P. Aldana , D. Klawinski , C. Morris , R. Mailhot","doi":"10.1016/j.ijrobp.2024.11.023","DOIUrl":"10.1016/j.ijrobp.2024.11.023","url":null,"abstract":"<div><h3>Objectives</h3><div>Due to its rarity, no standard treatment guidelines exist for LGGS. Proton therapy (PT) offers an attractive modality to minimize toxicity. To date no clinical outcomes on PT in LGGS have been reported. Herein, we present a series of pediatric patients who received PT for progressive LGGS.</div></div><div><h3>Methods</h3><div>We identified 8 consecutive patients with non-metastatic LGGS treated with PT between 2012 and 2022. We utilized the cumulative incidence method to estimate local control (LC), freedom from distant metastases (FFDM), freedom from progression (FFP), and overall survival (OS). Treatment related toxicity was assessed according to the CTCAEv5.</div></div><div><h3>Results</h3><div>The median age at diagnosis was 4 years. All patients underwent attempted resection. Pilocytic astrocytoma was the most common tumor histology (n=4). All patients developed recurrence/progression of disease prior to referral for PT, with 3 having ≥ 2 recurrences prior to referral. The median duration between initial surgery and PT was 4.4 years. The median age at the start of PT was 8 years. Most patients (n=5) received PT as ≥ third line treatment. Seven patients were treated with PT to the primary tumor. Most patients (n=7) received between 45-50.4 CGE. Median follow up was 7.8 years. The 10-year KM estimates for LC, FFDM, FFP, and OS were 85%, 88%, 73%, and 55% respectively. One patient experienced malignant transformation and 2 developed pseudoprogression following PT. No pulmonary, gastrointestinal, or musculoskeletal toxicity was observed during or after PT. No patients had ≥ grade 3 radiation related adverse events.</div></div><div><h3>Conclusions</h3><div>Despite negative selection bias, with many patients having multiple recurrences prior to referral for PT, our experience suggests PT for pediatric LGGS offers long-term disease control with limited acute and late side effects. The favorable therapeutic ratio of PT suggests it should be considered among first-line therapy in children with non-metastatic, unresectable LGGS.</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":"143172249","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}

引用次数: 0