Cancer Mortality Among Adolescents and Young Adults (15–29 Years Old) According to the Population Size of Brazilian Municipalities

Oliveira, Max Moura de; Nomellini, Patrícia Ferreira; Curado, María Paula

doi:10.1089/jayao.2018.0096

Cited by 1 publication

(1 citation statement)

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“…There is also no international consensus on the age criteria definition for AYAs. The age group 15‐39 years was used by the United States (US) National Cancer Institute, 1 Canadian, 17 French, 18 Southern, and Eastern Europe registries 19 ; 15‐29 years by the Netherlands 20 and Brazilian registries 21 ; 13‐24 years by the English 22 and Finnish registries 23 . Outcomes may also differ depending on whether benign tumors were included for their analysis.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of adolescents and young adults treated for brain and skull base tumors with pencil beam scanning proton therapy

Lim

Tran

Kroeze

et al. 2020

Pediatric Blood & Cancer

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Background: The use of proton therapy (PT) in adolescents and young adults (AYAs) is becoming increasingly popular. This study aims to assess the outcomes and late toxicity consequences in AYAs (15-39 years) with brain/skull base tumors treated with pencil beam scanning proton therapy. Methods: One hundred seventy six AYAs treated curatively at the Paul Scherrer Institute (PSI) were identified. Median age was 30 years (range 15-39) and median prescribed dose was 70.0 Gy (relative biological effectiveness [RBE]) (range 50.4-76.0). The most common tumors treated were chordomas/chondrosarcomas (61.4%), followed by gliomas (15.3%), and meningiomas (14.2%). Results: After a median follow up of 66 months (range 12-236), 24 (13.6%) local only failures and one (0.6%) central nervous system (CNS) distant only failure were observed. The 6-year local control, distant progression-free survival, and overall survival were 83.2%, 97.4%, and 90.2%, respectively. The 6-year high-grade (≥grade [G] 3) PT-related late toxicity-free survival was 88.5%. Crude late toxicity rates were 26.2% G1, 37.8% G2, 12.2% G3, 0.6% G4, and 0.6% G5. The one G4 toxicity was a retinopathy and one G5 toxicity was a brainstem hemorrhage. The 6-year cumulative incidences for any late PT-related pituitary, ototoxicity, and neurotoxicity were 36.3%, 18.3%, and 25.6%; whilst high-grade (≥G3) ototoxicity and neurotoxicity were 3.4% and 2.9%, respectively. No secondary malignancies were observed. The rate of unemployment was 9.5% pre-PT, increasing to 23.8% post-PT. Sixty-two percent of survivors were working whilst 12.7% were in education post-PT. Conclusions: PT is an effective treatment for brain/skull base tumors in the AYA population with a reasonable late toxicity profile. Despite good clinical outcomes, around one in four AYA survivors are unemployed after treatment.

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