Proton beam therapy in pediatric brain tumor patients: improved radiation delivery techniques improve neurocognitive outcomes

Jalali, Rakesh; Goda, Jayant Sastri

doi:10.1093/neuonc/noz085

Cited by 4 publications

(2 citation statements)

References 10 publications

(11 reference statements)

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“…Longer survival than SBRT, spares more normal liver cells from radiation damage than treating with conventional RT [39][40][41] Esophageal Proton vs. IMRT Randomized Phase II The mean total toxicity burden was considerably lower with protons than with IMRT [42] Brain (Adult) Proton Trial study unknown Significantly reduced the side effects and better neurocognition over time after treatment [43][44][45][46] Brain (Pediatric) Proton vs. Photon Trial study unknown Spared more surrounding normal tissue; reduced side effects and increased five-year survival rates (72-100%) [32,[47][48][49][50] Safer to deliver high dose of radiation and better neurocognition [44][45][46]51] 2.3.2. Carbon Ion Therapy 12 C ions are the optimal ion for treating deep-seated tumors, because the higher relative biological effectiveness (RBE) resulting from variations in linear energy transfer (LET) along the ion path can be limited to the tumor volume with minimal normal tissue injury along the entrance track.…”

Section: Proton Therapymentioning

confidence: 99%

Immunomodulatory Effects of Radiotherapy

Kumari

Mukherjee

Sinha

et al. 2020

IJMS

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Radiation therapy (RT), an integral component of curative treatment for many malignancies, can be administered via an increasing array of techniques. In this review, we summarize the properties and application of different types of RT, specifically, conventional therapy with x-rays, stereotactic body RT, and proton and carbon particle therapies. We highlight how low-linear energy transfer (LET) radiation induces simple DNA lesions that are efficiently repaired by cells, whereas high-LET radiation causes complex DNA lesions that are difficult to repair and that ultimately enhance cancer cell killing. Additionally, we discuss the immunogenicity of radiation-induced tumor death, elucidate the molecular mechanisms by which radiation mounts innate and adaptive immune responses and explore strategies by which we can increase the efficacy of these mechanisms. Understanding the mechanisms by which RT modulates immune signaling and the key players involved in modulating the RT-mediated immune response will help to improve therapeutic efficacy and to identify novel immunomodulatory drugs that will benefit cancer patients undergoing targeted RT.

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Section: Proton Therapymentioning

confidence: 99%

Immunomodulatory Effects of Radiotherapy

Kumari

Mukherjee

Sinha

et al. 2020

IJMS

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“…1 Radiation treatment is a life-saving intervention that can be associated with neurocognitive, emotional, and behavioral sequalae, [2][3][4][5][6][7] although the use of proton radiation treatment (PRT) has yielded more favorable outcomes due to its dose-sparing properties. [8][9][10] Many studies examining the outcomes of PRT revealed cognitive and adaptive functioning in the normal range more than 3 years post-treatment; [11][12][13] however, adaptive functioning challenges at 5 years post-PRT have been observed, with greater vulnerability in survivors treated with craniospinal irradiation (CSI). 12 Studies of psychosocial and executive functioning outcome following PRT in pediatric brain tumor survivors are relatively recent, and require replication to strategically guide intervention.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial and Executive Functioning Outcomes in Pediatric Brain Tumor Survivors After Proton Radiation

Grieco

Evans

Yock

et al. 2022

Preprint

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Background: Pediatric brain tumor survivors can experience detrimental effects from radiation treatment. This cross-sectional study examined psychosocial and executive functioning in pediatric patients treated with proton radiation (PRT). Procedure: Parents of 187 brain tumor survivors completed standardized scales ≥1 year after PRT. One-way analysis of variance, Pearson correlation, and chi-square analysis were used to determine the impact of demographic, diagnostic or treatment-related characteristics. One-sample t-tests compared mean scores with published normative means. Rates of impairment (T-score >65) were calculated. Results: Mean age at PRT (baseline) was 8.49 years; mean follow-up interval 3.84 years. Approximately one-third (36.9%) received craniospinal irradiation (CSI). All mean T-scores for psychosocial and executive functioning were within the normal range. Younger age at baseline correlated with more behavior problems; older age with more problems with adaptive skills. Baseline age was not correlated with executive functioning. Follow-up interval and radiation field (CSI; focal) were not related to psychosocial or executive problems. Significantly elevated mean T-scores were in withdrawal ( p<0.001) and metacognitive skills (e.g., working memory p<0.001); significantly lower ( p<0.05) in hyperactivity, aggression, conduct problems, adaptability, social skills, and behavioral regulation. Rates of impairment far exceeded expectation in overall metacognitive skills (18.7%), withdrawal (17.9%), and activities of daily living (15.0%). Impairment rates were not related to age at PRT or radiation field. Conclusions: Psychosocial and executive functioning was within the normal range, on average, at follow-up. However, elevated impairment rates were observed in specific aspects of functioning (e.g., withdrawal, metacognitive executive functioning). Targeted screening and proactive intervention are needed.

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A type of brain-targeting nano-formulation and its anti-tumour effect in paediatric brain tumour cells

Tian,

Shi,

et al. 2024

Materials Technology

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Proton beam therapy in pediatric brain tumor patients: improved radiation delivery techniques improve neurocognitive outcomes

Cited by 4 publications

References 10 publications

Immunomodulatory Effects of Radiotherapy

Immunomodulatory Effects of Radiotherapy

Psychosocial and Executive Functioning Outcomes in Pediatric Brain Tumor Survivors After Proton Radiation

A type of brain-targeting nano-formulation and its anti-tumour effect in paediatric brain tumour cells

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