Paediatric brain tumours: A review of radiotherapy, state of the art and challenges for the future regarding protontherapy and carbontherapy

Proton radiotherapy should be further developed in Poland

“…reducing the risk of adverse events [17,18]. The efficacy studies for proton beam radiotherapy on CNS cancers indicate high rates of overall survival [17]. Reducing the number of complications to healthy organs has been confirmed in numerous dosimetric and modelling studies showing decreased risks of: cardiac toxicity [19], premature radiotherapy-related ovarian failure [20], ototoxicity [21] or cognitive impairment [22].…”

“…In cases of central nervous system (CNS) cancers in children, using proton radiotherapy is justified especially to those cases requiring irradiation of the cerebrospinal axis, pinealoblastoma, other primitive neuroectodermal tumours (PNETs; currently classified in 2016 according to the WHO as CNS cancers but not otherwise classified), anaplastic ependymoma (with documented dissemination into the cerebrospinal fluid) and choroid plexus carcinoma [17].…”

“…reducing the risk of adverse events [17,18]. The efficacy studies for proton beam radiotherapy on CNS cancers indicate high rates of overall survival [17].…”

“…Indeed, the first clinical data has now emerged on improved Health-Related Quality of Life (HRQoL) in patients after receiving proton irradiation in childhood compared to photon therapy [23]. It appears there is unequivocal evidence supporting the use of proton therapy for low-grade gliomas in children in terms of dose distribution to critical organs and toxicity [17,24]. Indications on using proton radiotherapy for cases of highly differentiated gliomas should be established, given that they are the most commonly diagnosed brain tumours in children and thus constitute the most common cause for employing brain radiotherapy to this age group [17].…”

“…It appears there is unequivocal evidence supporting the use of proton therapy for low-grade gliomas in children in terms of dose distribution to critical organs and toxicity [17,24]. Indications on using proton radiotherapy for cases of highly differentiated gliomas should be established, given that they are the most commonly diagnosed brain tumours in children and thus constitute the most common cause for employing brain radiotherapy to this age group [17]. The value-added benefit of proton beam radiotherapy is also increased when cases of soft tissue sarcoma [25], chordoma and chondrosarcoma [26] and retinoblastoma [27] are diagnosed.…”