Abdominal cancer during early childhood: A dosimetric comparison of proton beams to standard and advanced photon radiotherapy

Hillbrand, Martin; Georg, Dietmar; Gadner, Helmut; Pötter, Richard; Dieckmann, Karin

doi:10.1016/j.radonc.2008.06.012

Cited by 49 publications

(36 citation statements)

References 36 publications

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“…However, these new risk models are still under development and may contain unknown large errors. We therefore decided to follow the BEIR VII report and use ratios of risks instead of absolute risk values of second cancer because several independent studies suggested the former to be a more robust measure for comparing treatment modalities [13,14,32,33]. The good agreement of RLAR values between Brodin et al [13] and the present work provided more strong evidence that a ratio of risks should be used for inter-institution comparisons.…”

Section: Discussionmentioning

confidence: 63%

A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation

Zhang

Howell

Taddei

et al. 2014

Radiotherapy and Oncology

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Purpose To compare the risks of radiogenic second cancers and cardiac mortality in 17 pediatric medulloblastoma patients treated with passively scattered proton or field-in-field photon craniospinal irradiation (CSI). Material/ methods Standard of care photon or proton CSI treatment plans were created for all 17 patients in a commercial treatment planning system (TPS) (Eclipse version 8.9; Varian Medical Systems, Palo Alto, CA) and prescription dose was 23.4 Gy or 23.4 Gy(RBE) to the age specific target volume at 1.8 Gy/fraction. The therapeutic doses from proton and photon CSI plans were estimated from TPS. Stray radiation doses were determined from Monte Carlo simulations for proton CSI and from measurements and TPS for photon CSI. The Biological Effects of Ionization Radiation VII report and a linear model based on childhood cancer survivor data were used for risk predictions of second cancer and cardiac mortality, respectively. Results The ratios of lifetime attributable risk (RLARs) (proton/photon) ranged from 0.10 to 0.22 for second cancer incidence and ranged from 0.20 to 0.53 for second cancer mortality, respectively. The ratio of relative risk (RRR) (proton/photon) of cardiac mortality ranged from 0.12 to 0.24. The RLARs of both cancer incidence and mortality decreased with patient's age at exposure (e), while the RRRs of cardiac mortality increased with e. Girls had a significantly higher RLAR of cancer mortality than boys. Conclusion Passively scattered proton CSI provides superior predicted outcomes confers lower predicted risks of a second cancer and cardiac mortality than field-in-field photon CSI for all medulloblastoma patients in a large clinically representative sample in the United States, but the magnitude of superiority depend strongly on the patients' anatomical development status.

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Section: Discussionmentioning

confidence: 63%

A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation

Zhang

Howell

Taddei

et al. 2014

Radiotherapy and Oncology

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“…Similarly, dose fractionation is also believed to modulate the induction of mutations and hence the cancer risk (15)(16)(17). A model proposed to account for these effects (4) had been employed in recent years for several risk analyses in clinical patient groups (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Secondary Malignancies From Prostate Cancer Radiation Treatment: A Risk Analysis of the Influence of Target Margins and Fractionation Patterns

Daşu

Toma-Daşu

Franzén

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…Proton beam therapy for mucoepidermoid carcinoma neighboring tissue via a small number of ports (15,16). Using a photon beam, repeated radiotherapy for the mediastinum and extended chest wall is limited by toxicity in the heart, esophagus and spinal cord, especially for a growing patient.…”

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confidence: 99%

Proton Beam Therapy for Inoperable Recurrence of Bronchial High-grade Mucoepidermoid Carcinoma

Kanemoto

Oshiro

Sugahara

et al. 2012

Japanese Journal of Clinical Oncology

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We report the case of a 17-year-old patient who received four courses of proton beam therapy for inoperable recurrent high-grade bronchial mucoepidermoid carcinoma of the chest wall and lymph nodes. The equivalent doses in conventional fractionation of 79.2 -80.6 Gy were applied to the tumor from the first to third courses of proton beam therapy; the hemi-chest wall was also irradiated prophylactically in the third course. The irradiated tumor recurred marginally and liver metastasis developed, but tumor size within the irradiated field was suppressed. Proton beam therapy was also applied to the marginally recurrent tumor in the fourth course. The patient died of cancer about 5 years after the first course of proton beam therapy-about 9 years after the initial diagnosis and surgery. Repeated irradiation of the mediastinum and chest wall with photon radiotherapy is often limited by side-effects in the heart, esophagus and spinal cord. However, no severe late complications in critical organs were detected in this case. Only a Grade 2 skin reaction and lymphatic edema were observed. Therefore, high-dose proton beam therapy may be an option as a salvage therapy with less toxicity to normal tissues compared with photon radiotherapy and provide an alternative to repeated surgery.

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Abdominal cancer during early childhood: A dosimetric comparison of proton beams to standard and advanced photon radiotherapy

Cited by 49 publications

References 36 publications

A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation

A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation

Secondary Malignancies From Prostate Cancer Radiation Treatment: A Risk Analysis of the Influence of Target Margins and Fractionation Patterns

Proton Beam Therapy for Inoperable Recurrence of Bronchial High-grade Mucoepidermoid Carcinoma

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