Challenges of repetitive sedation in a 16-month old child undergoing proton beam therapy

Daivam, Indumathi; Murugesan, Anand; Jalali, Rakesh

doi:10.4103/ija.ija_1374_20

Cited by 1 publication

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“…Thirteen of our paediatric patients required sedation for treatment, of which ten required it daily for the entirety of treatment. The younger age, longer positioning and treatment time, and stringent immobilisation requirements necessitate deep sedation, and therefore the inclusion of a skilled paediatric anaesthetist in the treating team is of paramount importance [18]. With growing familiarity, increased comfort level and rapport with the treatment team, daily sedation for treatment could be avoided in three patients within a week of starting treatment.…”

Section: Discussionmentioning

confidence: 99%

Successful Implementation of Image-Guided Pencil-Beam Scanning Proton Therapy in Medulloblastomas

Das,

Gaikwad,

Krishnan

et al. 2023

Diagnostics

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Medulloblastoma is the most common malignant brain tumour in children, while much rarer in adults. Although the prognosis and outcomes have greatly improved in the era of modern multidisciplinary management, long-term treatment-induced toxicities are common. Craniospinal irradiation followed by a boost to the primary and metastatic tumour sites forms the backbone of treatment. Proton therapy has been endorsed over conventional photon-based radiotherapy due to its superior dosimetric advantages and subsequently lower incidence and severity of toxicities. We report here our experience from South-East Asia’s first proton therapy centre of treating 40 patients with medulloblastoma (38 children and adolescents, 2 adults) who received image-guided, intensity-modulated proton therapy with pencil-beam scanning between 2019 and 2023, with a focus on dosimetry, acute toxicities, and early survival outcomes. All patients could complete the planned course of proton therapy, with mostly mild acute toxicities that were manageable on an outpatient basis. Haematological toxicity was not dose-limiting and did not prolong the overall treatment time. Preliminary data on early outcomes including overall survival and disease-free survival are encouraging, although a longer follow-up and data on long-term toxicities are needed.

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Section: Discussionmentioning

confidence: 99%