Proton versus conventional radiotherapy for pediatric salivary gland tumors: Acute toxicity and dosimetric characteristics.

Abstract

Purpose-We evaluated acute toxicity profiles and dosimetric data for children with salivary gland tumors treated with adjuvant photon/electron-based radiation therapy (X/E RT) or proton therapy (PRT). Methods and Materials-We identified 24 patients who had received adjuvant radiotherapy for salivary gland tumors. Data was extracted from the medical records and the treatment planning systems. Toxicity was scored according to the Common Terminology Criteria for Adverse Effects 4.0. Results-Eleven patients received X/E RT and 13 PRT, with a median prescribed dose of 60 Gy in each group. In the X/E RT group, 54% of patients developed acute grade II/III dermatitis, 27% grade II/III dysphagia, and 91% grade II/III mucositis, and the median weight loss was 5.3% with one patient requiring feeding tube placement. In the PRT group, 53% had acute grade II/III dermatitis, 0% grade II/III dysphagia, and 46% grade II/III mucositis, with a median weight gain of 1.2%. Additionally, PRT was associated with lower mean doses to several normal surrounding midline and contralateral structures.

Mandibular growth in survivors of pediatric parotid gland carcinoma treated with interstitial brachytherapy

“…Moreover, about half of the parotid gland tumors are malignant in the pediatric population; of these, mucoepidermoid carcinoma is the most common . Nevertheless, pediatric patients with this malignancy have favorable prognosis, with 5 year overall survival above 80% . The rates of nodal involvement and systematic metastasis are relatively lower in the pediatric population than is the case for salivary gland carcinomas in the adult population .…”

“…Nevertheless, adjunctive radiotherapy may be indicated for high‐risk cases, including tumors with high grades, perineural invasion, incomplete resection, or nodal involvement . There is no clear dose–effect relationship; nevertheless, it is noteworthy that subsequent asymmetry deformity is one of the complications of radiotherapy . Arrested mandibular growth requiring reconstructive surgery may occur because of mandibular and maxillary growth retardation .…”

“…1,[3][4][5] Nevertheless, pediatric patients with this malignancy have favorable prognosis, with 5 year overall survival above 80%. 1,[4][5][6][7][8][9] The rates of nodal involvement and systematic Abbreviations: 3D, three dimensional; BTPS, brachytherapy treatment planning system; cGy, centigray; CT, computed tomography; CTV, clinical target volume; D90, the dose delivered to 90% of the target volume; Gy, gray; MBq, megabecquerels; mm 3 , cubic millimeter; V100, the percentage of the target volume receiving at least 100% of the prescription dose metastasis are relatively lower in the pediatric population than is the case for salivary gland carcinomas in the adult population. 1,4 Surgery is the mainstay treatment, but the effects of radiotherapy are unclear.…”

“…[2][3][4]7,10 There is no clear doseeffect relationship; nevertheless, it is noteworthy that subsequent asymmetry deformity is one of the complications of radiotherapy. 4,6 Arrested mandibular growth requiring reconstructive surgery may occur because of mandibular and maxillary growth retardation. 6,11 Interstitial brachytherapy is effective and safe for pediatric patients with parotid gland carcinomas, according to our previous study.…”

“…4,6 Arrested mandibular growth requiring reconstructive surgery may occur because of mandibular and maxillary growth retardation. 6,11 Interstitial brachytherapy is effective and safe for pediatric patients with parotid gland carcinomas, according to our previous study. 12,13 The aim of the study was to present long-term results of mandibular growth in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy.…”