Proton beam therapy for children and adolescents and young adults (AYAs): JASTRO and JSPHO Guidelines

Mizumoto, Masashi; Fuji, Hiroshi; Miyachi, Mitsuru; Soejima, Toshinori; Yamamoto, Tetsuya; Aibe, Norihiro; Demizu, Yusuke; Iwata, Hiromitsu; Hashimoto, Takayuki; Motegi, Atsushi; Kawamura, Atsufumi; Terashima, Keita; Fukushima, Takashi; Nakao, Tomohei; Takada, Akinori; Sumi, Minako; Oshima, Junjiro; Moriwaki, Kensuke; Nozaki, Miwako; Ishida, Yuji; Kosaka, Yoshiyuki; Ae, Keisuke; Hosono, Ako; Harada, Hideyuki; Ogo, Etsuyo; Akimoto, Tetsuo; Saito, Takashi; Fukushima, Hiroko; Suzuki, Ryoko; Takahashi, Mitsuru; Matsuo, Takayuki; Matsumura, Akira; Masaki, Hidekazu; Hosoi, Hajime; Shigematsu, Naoyuki; Sakurai, Hideyuki

doi:10.1016/j.ctrv.2021.102209

Cited by 20 publications

(19 citation statements)

References 132 publications

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“…JASTRO/JSHO guidelines and ASTRO model policy recommend proton therapy for pediatric tumors to reduce secondary cancers and late adverse events ( 11 , 12 ). Since our hospital uses proton therapy for pediatric tumors ( 13 – 18 ), most of the current analysis involved proton therapy, with only a few cases treated with photon radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Light flash and odor during proton beam therapy for pediatric patients: a prospective observational study

et al. 2022

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Light flash and odor during radiation therapy are well-known phenomena, but the details are poorly understood, particularly in pediatric patients. Therefore, we conducted a prospective observational study of these events in pediatric patients (age ≤20 years old) who received radiotherapy at our center from January 2019 to November 2021. Light flash and odor were evaluated using a patient-reported checklist including the presence, strength, and duration of the phenomenon, and color of light or type of odor. 53 patients who received proton therapy (n=47) and photon radiotherapy (n=6) were enrolled in this study. The median age of the patients was 10, ranged from 5 to 20. The patients who was able to see the light flash was 4, and all of them received retina irradiation. This was equivalent to 57% of the patients who received radiotherapy to retina (n=7). The light was bright and colored mainly blue and purple, which seemed to be consistent with Cherenkov light. Odor was sensed by 9 (17%) patients, and seven patients of the 9 received nasal cavity irradiation. This was equivalent to 41% of the patients who received nasal cavity irradiation (n=17). Other 2 patients received proton therapy to brain tumor. The odors were mainly described as plastic, burnt and disinfectant, which may be caused by ozone generated during irradiation. These data suggest that pediatric patients with retinal and nasal cavity irradiation frequently sense light flashes or odor. So adequate care is necessary so that these patients are not worried about this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Light flash and odor during proton beam therapy for pediatric patients: a prospective observational study

et al. 2022

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“…Secondary electrons have a range of a few centimeters and it is possible that these electrons may hit the retina, olfactory membrane or olfactory bulb. We also note that radiation therapy is essential for treatment of pediatric tumors [10] and our results indicate that children are more likely to sense light ashes and odors. Therefore, it should be kept in mind that inclusion of the visual pathway or nasal cavity in the irradiation range in pediatric cases makes it likely that the patient will sense light and odor.…”

Section: Discussionmentioning

confidence: 51%

Retrospective analysis of the areas responsible for light flash and odor during proton beam therapy and photon therapy

Oshiro

Mizumoto

Miyamoto

et al. 2023

Preprint

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“…До настоящего времени нет единых рекомендаций по использованию ПЛТ в онкопедиатрии. В 2016 г. в Японии было создано первое руководство по исполь зованию данного метода в детской практике [38].…”

Section: Type Of Toxicityunclassified

Proton beam therapy in pediatric patients with central nervous system tumors: method features, clinical data analysis

Smirnova

Радулеску²,

Vorobyov

et al. 2023

Ross. ž. det. gematol. onkol.

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Introduction. Central nervous system (CNS) tumors are the most common pediatric solid tumor, that need multimodality treatment approach including surgery, intensive chemotherapy (CT) and radiotherapy (RT). Due to toxicity, mostly late, RT has limited use in children, especially those under 3 years of age. The physical characteristics of proton beam therapy (PBT) minimize the risk and types of toxicity compared to photons, making it the preferred choice for pediatric use. Aim – to analyze the experience of PBT in patients under 18 years of age with various types of CNS malignancies, the assessment of risk factors for acute and late toxicity and its clinical manifestations. Materials and methods. A retrospective analysis of 63 courses of PBT performed in 58 patients with CNS malignancies for the period from 2018 to 2022 was carried out on Proton Center of the Sergey Beresin Medical Institute. The manifestations of local and systemic toxicity (predominantly acute) were analyzed, with an assessment of the influence of age, the volume of RT, the use of previous and concomitant CT on the severity of adverse events (AE). Results. In the study cohort, patients with embryonal CNS malignancies predominated (72.3 %). Median age was 5 years 2 months, median follow-up was 15 months. In 36 % of cases, a complete response was achieved by the start of PBT. Patients with craniospinal irradiation (CSI) prevailed (60 %). Among the manifestations of toxicity, AE grade I–II predominated. The most common AE were local reactions (dermatitis (84 %), focal alopecia (96 %)). Among systemic AE, hematological complications (84 %) were the most often occurred. A more pronounced toxicity profile was registered in the group with CSI, while concomitant CT, the patient’s age, previous CT did not significantly affect the severity of most of the assessed AE parameters (p > 0.05). The analysis of late toxic effects was difficult due to the short follow-up period, the cumulative effect of other treatment modalities on the AE’s development. The reported complications included persistent focal alopecia (14 % of cases), endocrinopathies (7 %), neurological manifestations (6 %). One (2 %) child had a severe neurological deficit, secondary epilepsy with psychomotor regression, which can also be associated with the potentiating effect of previous CT and high-dose CT. Conclusion. The analysis of our data and literature review allows to conclude that PBT has relatively low toxicity profile, which is the determining factor for choosing this method of RT in pediatric patients. The main risk factor of AE’s was CSI. The acceptable acute toxicity of repeat PBT makes it possible to be used in pts with disease progression or relapse in case of absence of alternative therapeutic options.

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Proton beam therapy for children and adolescents and young adults (AYAs): JASTRO and JSPHO Guidelines

Cited by 20 publications

References 132 publications

Light flash and odor during proton beam therapy for pediatric patients: a prospective observational study

Light flash and odor during proton beam therapy for pediatric patients: a prospective observational study

Retrospective analysis of the areas responsible for light flash and odor during proton beam therapy and photon therapy

Proton beam therapy in pediatric patients with central nervous system tumors: method features, clinical data analysis

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