Daniel J Indelicato1, Julie A Bradley1, Eric S Sandler2, Philipp R Aldana3, Amy Sapp1, Jennifer E Gains4, Adrian Crellin4, Ronny L Rotondo1. 1. Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida. 2. Department of Pediatric Hematology/Oncology, Nemours Children's Health System, Jacksonville, Florida. 3. Department of Neurosurgery, University of Florida College of Medicine, Jacksonville, Florida. 4. NHS England Radiotherapy Clinical Reference Group, London, United Kingdom.
Abstract
BACKGROUND: International, multidisciplinary care of children with central nervous system (CNS) tumors presents unique challenges. The aim of this study is to report patient outcomes of U.K. children referred for proton therapy to a North American facility. METHODS: From 2008 to 2016, 166 U.K. children with approved CNS tumors were treated with proton therapy at a single academic medical center in the United States. Median age was 7 years (range, 1-19). Median follow-up was 2.6 years. RESULTS: The 3-year actuarial overall survival (OS) and local control (LC) rates were 96% and 91%, respectively, for the overall group, 92% and 85% for the ependymoma subgroup (n = 57), 95% and 88% for the low-grade glioma subgroup (n = 54), and 100% and 100%, respectively, for the craniopharyngioma subgroup (n = 45). Cyst expansion was observed in 13 patients, including one case resulting in visual impairment. Serious side effects included new-onset seizures in three patients (1.8%), symptomatic vasculopathy in three patients (1.8%), and symptomatic brainstem necrosis in one patient (0.6%). CONCLUSIONS: In this cohort of British children referred overseas for proton therapy, disease control does not appear compromised, toxicity is acceptable, and improvement in long-term function is anticipated in survivors owing to the reduced brain exposure afforded by proton therapy.
BACKGROUND: International, multidisciplinary care of children with central nervous system (CNS) tumors presents unique challenges. The aim of this study is to report patient outcomes of U.K. children referred for proton therapy to a North American facility. METHODS: From 2008 to 2016, 166 U.K. children with approved CNS tumors were treated with proton therapy at a single academic medical center in the United States. Median age was 7 years (range, 1-19). Median follow-up was 2.6 years. RESULTS: The 3-year actuarial overall survival (OS) and local control (LC) rates were 96% and 91%, respectively, for the overall group, 92% and 85% for the ependymoma subgroup (n = 57), 95% and 88% for the low-grade glioma subgroup (n = 54), and 100% and 100%, respectively, for the craniopharyngioma subgroup (n = 45). Cyst expansion was observed in 13 patients, including one case resulting in visual impairment. Serious side effects included new-onset seizures in three patients (1.8%), symptomatic vasculopathy in three patients (1.8%), and symptomatic brainstem necrosis in one patient (0.6%). CONCLUSIONS: In this cohort of British children referred overseas for proton therapy, disease control does not appear compromised, toxicity is acceptable, and improvement in long-term function is anticipated in survivors owing to the reduced brain exposure afforded by proton therapy.
Authors: Neil G Burnet; Ranald I Mackay; Ed Smith; Amy L Chadwick; Gillian A Whitfield; David J Thomson; Matthew Lowe; Norman F Kirkby; Adrian M Crellin; Karen J Kirkby Journal: Br J Radiol Date: 2020-01-14 Impact factor: 3.039
Authors: Roberta Rudà; Guido Reifenberger; Didier Frappaz; Stefan M Pfister; Anne Laprie; Thomas Santarius; Patrick Roth; Joerg Christian Tonn; Riccardo Soffietti; Michael Weller; Elizabeth Cohen-Jonathan Moyal Journal: Neuro Oncol Date: 2018-03-27 Impact factor: 12.300