Endocrine outcomes with proton and photon radiotherapy for standard risk medulloblastoma

Eaton, Bree R.; Esiashvili, Natia; Kim, Sungjin; Patterson, Briana; Weyman, Elizabeth A.; Thornton, Lauren T.; Mazewski, Claire; MacDonald, Tobey J.; Ebb, David H.; MacDonald, Shannon M.; Tarbell, Nancy J.; Yock, Torunn I.

doi:10.1093/neuonc/nov302

Cited by 136 publications

(111 citation statements)

References 33 publications

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“…1) (12). Changes in the delivery of radiation, such as the use of proton radiotherapy, may modify the risk or the latency period for the onset of HP axis dysfunction (13,14,15).…”

Section: Hp Axis Dysfunctionmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

Chemaitilly

Cohen

2017

European Journal of Endocrinology

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Endocrine complications are frequently observed in childhood cancer survivors (CCS). One of two CCS will experience at least one endocrine complication during the course of his/her lifespan, most commonly as a late-effect of cancer treatments, especially radiotherapy and alkylating agent chemotherapy. Endocrine late-effects include impairments of the hypothalamus/pituitary, thyroid and gonads, as well as decreased bone mineral density and metabolic derangements leading to obesity and/or diabetes mellitus. A systematic approach where CCS are screened for endocrine late-effects based on their cancer history and treatment exposures may improve health outcomes by allowing the early diagnosis and treatment of these complications.

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“…1) (12). Changes in the delivery of radiation, such as the use of proton radiotherapy, may modify the risk or the latency period for the onset of HP axis dysfunction (13,14,15).…”

Section: Hp Axis Dysfunctionmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

Chemaitilly

Cohen

2017

European Journal of Endocrinology

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“…Proton-based radiotherapy, a technique that seeks to exploit the decreased propensity of protons to travel beyond a targeted site in comparison to photons, has been recently introduced with the aim of decreasing even further the exposure of normal tissues located in proximity to the treated tumor [11]. Currently, only a limited number of institutions offer proton-based radiotherapy and only a small number of studies, all with short follow-up durations, have reported data on endocrine late effects in children treated with proton-based radiotherapy, so the long-term risks remain unknown [12, 13]. …”

Section: The Effect Of Radiotherapymentioning

confidence: 99%

“…Deficiencies in LH/FSH, TSH, and ACTH have been associated with HP radiotherapy at doses ≥30 Gy and hyperprolactinemia with even higher doses ≥40 Gy [17-19]. Efforts to improve the precision of the delivery of radiotherapy, as with the use of protons instead of photons, are likely to decrease scatter to the HP region and may hopefully reduce or delay the appearance of HP dysfunction especially in individuals treated for tumors located outside the HP region [13]. …”

Section: The Effect Of Radiotherapymentioning

confidence: 99%

“…Thyroid complications observed after CSI include primary hypothyroidism, hyperthyroidism, and thyroid cancer [7, 25]. The use of proton-based radiotherapy for CSI holds promise in terms of decreasing the amount of scatter to the thyroid [13]. …”

Section: The Effect Of Radiotherapymentioning

confidence: 99%

“…The use of proton-based radiotherapy for CSI holds promise in terms of decreasing the amount of scatter to the ovaries [13]. The effect of scatter from CSI to the testes seems to be minor and unlikely to affect Leydig cell function, though it can potentially affect sperm production [26].…”

Section: The Effect Of Radiotherapymentioning

confidence: 99%

See 2 more Smart Citations

Childhood Cancer Treatments and Associated Endocrine Late Effects: A Concise Guide for the Pediatric Endocrinologist

Chemaitilly

Sklar

2018

Horm Res Paediatr

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Endocrine complications are frequently observed in childhood cancer survivors (CCS); in many instances, these complications develop months to years after the completion of cancer therapy. The estimated prevalence of endocrine late effects is 50% among CCS; the main risk factors are external beam radiation that includes key endocrine organs (the hypothalamus/pituitary, thyroid and gonads) and/or alkylating agents. Novel agents targeting tumor growth have increased the options available to a small number of patients albeit with the need for treatment over long periods of time. Some of these agents, such as certain tyrosine kinase inhibitors and immune system modulators have been shown to cause permanent endocrine deficits. This chapter offers a brief summary of the conventional treatment strategies for the most common cancers of childhood and a brief overview of the endocrine late effects most commonly associated with these exposures. The impact of targeted therapies on the endocrine system will also be discussed. The aim of this chapter is to provide basic guidance to the consulting pediatric endocrinologist in preparation for the clinical encounter with a CCS. A more detailed discussion of the management of specific endocrine late effects can be found in the other chapters in this series.

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Association of Race With Receipt of Proton Beam Therapy for Patients With Newly Diagnosed Cancer in the US, 2004-2018

et al. 2022

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Key Points Question Are there racial disparities in the use of proton beam therapy (PBT) among individuals newly diagnosed with cancer in the US? Findings In this cross-sectional study, Black patients were less likely to be treated with PBT than White patients, especially for cancers for which PBT is recommended over photon-based radiation therapy. The racial disparities in receipt of PBT increased over time despite increases in the number of facilities offering PBT in the US. Meaning These findings indicate that racial disparities in the use of PBT are substantial, especially for cancers for which PBT is the recommended radiation therapy modality, and that increased PBT availability did not help eliminate racial disparities for these cancers.

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Endocrine outcomes with proton and photon radiotherapy for standard risk medulloblastoma

Abstract: Proton radiotherapy may reduce the risk of some, but not all, radiation-associated late endocrine abnormalities.

Cited by 136 publications

References 33 publications

DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

DIAGNOSIS OF ENDOCRINE DISEASE: Endocrine late-effects of childhood cancer and its treatments

Childhood Cancer Treatments and Associated Endocrine Late Effects: A Concise Guide for the Pediatric Endocrinologist

Association of Race With Receipt of Proton Beam Therapy for Patients With Newly Diagnosed Cancer in the US, 2004-2018

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