Journal article
Proton versus photon radiotherapy for common pediatric brain tumors: Comparison of models of dose characteristics and their relationship to cognitive function
Pediatric blood & cancer, Vol.51(1), pp.110-117
07/01/2008
DOI: 10.1002/pbc.21530
PMID: 18306274
Abstract
Background. To determine whether proton radiotherapy has clinical advantages over photon radiotherapy, we modeled the dose characteristics of both to critical normal tissue volumes using data from patients with four types of childhood brain tumors. Procedures. Three-dimensional imaging and treatment planning data, including targeted tumor and normal tissues contours, were acquired for 40 patients, 10 each with optic pathway glioma (OPG), craniopharyngioma (CR), infratentorial ependymoma (EP), or medulloblastoma (MB). Dose-volume data were collected for the entire brain, temporal lobes, cochlea, and hypothalamus from each patient. The data were averaged and compared based on treatment modality (protons vs. photons) using dose-cognitive effects models. Outcomes were estimated over 5 years. Results. Relatively small critical normal tissue volumes such as the cochlea and hypothalamus may be spared from radiation exposure when not adjacent to the primary tumor volume. Larger normal tissue volumes such as the supratentorial brain or temporal lobes receive less of the low and intermediate doses. When applied to longitudinal models of radiation dose-cognitive effects, these differences resulted in clinically significant higher IQ scores for patients with MB and CR and academic reading scores in patients with OPG. Extreme differences between proton and photon dose distributions precluded meaningful comparison of protons and photons for patients with EP. Conclusions. Differences in the overall dose distributions, as indicated by modeling changes in cognitive function, showed that a reduction in the lower-close volumes or mean dose would have long-term, clinical advantages for children with MB, CR, and OPC.
Details
- Title: Subtitle
- Proton versus photon radiotherapy for common pediatric brain tumors: Comparison of models of dose characteristics and their relationship to cognitive function
- Creators
- Thomas E. Merchant - St. Jude Children's Research HospitalChia-Ho Hua - St Jude Childrens Hosp, Div Radiat Oncol, Memphis, TN 38105 USAHemant Shukla - St. Jude Children's Research HospitalXiaofei Ying - St Jude Childrens Hosp, Div Radiat Oncol, Memphis, TN 38105 USASimeon Nill - German Cancer Research CenterUwe Oelfke - German Cancer Research Center
- Resource Type
- Journal article
- Publication Details
- Pediatric blood & cancer, Vol.51(1), pp.110-117
- Publisher
- Wiley
- DOI
- 10.1002/pbc.21530
- PMID
- 18306274
- ISSN
- 1545-5009
- eISSN
- 1545-5017
- Number of pages
- 8
- Grant note
- P30CA021765 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) 5 P30 CA21765-28; P30 CA021765 / NCI NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 07/01/2008
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984700459602771
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