The Pediatric Proton and Photon Therapy Comparison Cohort: Study Design for a Multicenter Retrospective Cohort to Investigate Subsequent Cancers After Pediatric Radiation Therapy

González, Amy Berrington de; Gibson, Todd M.; Lee, Choonsik; Albert, Paul S.; Griffin, Keith; Kitahara, Cari M.; Liu, Danping; Mille, Marie-Laure; Shin, Jungwook; Bajaj, B.; Flood, Timothy J.; Gallotto, Sara L.; Paganetti, Harald; Ahmed, Safia K.; Eaton, Bree R.; Indelicato, Daniel J.; Milgrom, Sarah A.; Palmer, Joshua D.; Baliga, Sujith; Poppe, Matthew M.; Tsang, Derek S.; Wong, Kenneth; Yock, Torunn I.

doi:10.1016/j.adro.2023.101273

Cited by 6 publications

(3 citation statements)

References 48 publications

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“…Of note, a recent study reported a 10-year cumulative incidence of solid SPC of 1.8% after intensity modulated radiotherapy for pediatric cancer [4] , in line with estimates from conventional radiotherapy despite a larger low-dose volume. Therefore, more clinical evidence is required to understand the effect of low-doses on SPC risks [18] , when available clinical data are so far not indicating an increased risk.…”

Section: Discussionmentioning

confidence: 99%

“…Knowledge of the SPC dose–response is restricted by limited follow-up time in clinical cohorts and available information of the dose exposure and combined therapies [18] , thus our risk estimates were based on both a linear and full-mechanistic model proposed by Schneider [10] . The latter took into account the effects of treatment fractionation on cell-repopulation and cell-killing, and derived based on data from the atomic bomb survivors and Hodgkin disease patients.…”

Section: Discussionmentioning

confidence: 99%

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Risk of second primary cancer from proton arc therapy of pediatric brain tumors

Toussaint,

Indelicato,

Muren

et al. 2023

Physics and Imaging in Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of second primary cancer from proton arc therapy of pediatric brain tumors

Toussaint,

Indelicato,

Muren

et al. 2023

Physics and Imaging in Radiation Oncology

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“…Recent years have witnessed remarkable technological advances in RT that have improved the precision of the dose distribution to deep-seated tumors [1]. A clear example is protontherapy, whose physical properties ensure greater sparing of healthy tissue than photon-based conventional radiotherapy (CRT), thus abating the risk of RT-induced secondary cancers [2]-a crucial requirement, especially for pediatric patients [3]. However, this is of little avail against tumor radioresistance.…”

Section: Introductionmentioning

confidence: 99%

Fluorescence In Situ Hybridization-Based Chromosome Aberration Analysis Unveils the Mechanistic Basis for Boron-Neutron Capture Therapy’s Radiobiological Effectiveness

Elia,

Fede,

Bortolussi

et al. 2024

Applied Sciences

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Boron-Neutron Capture Therapy (BNCT) is a tumor-selective radiotherapy, based on the nuclear capture reaction 10B(n,α)7Li producing short range α-particles and recoiling 7Li nuclei exclusively confined to boron-enriched cancer cells. These particles possess high Linear Energy Transfer (LET) and mainly generate clustered DNA strand breaks, which are less faithfully restored by intracellular repair. Mis-rejoined breaks yield chromosome aberrations (CAs), which, for high-LET radiation, are more complex in nature than after sparsely ionizing photons/electrons used in conventional radiotherapy, which leads to increased cell-killing ability. However, such a radiobiological tenet of BNCT has been scantily studied at the DNA level. Therefore, the aim of this work was to evaluate CAs induced by BNCT in comparison to X-rays in genomically stable normal human epithelial mammary MCF10A cells. Two Fluorescence In Situ Hybridization (FISH)-based techniques were applied to calyculin A-induced prematurely condensed chromosomes: Whole Chromosome Painting and multicolor(m)-FISH. Not only did BNCT induce a greater CA frequency than X-ray irradiation, but m-FISH karyotype-wide analysis confirmed that CAs following BNCT exhibited a much higher degree of complexity compared to X-rays. To our knowledge, this is the first time that such evidence supporting the radiobiological superiority of BNCT has been shown.

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Is proton beam therapy always better than photon irradiation? Lessons from two cases

Li,

Yeo,

Gunewardena

et al. 2024

J of Medical Radiation Sci

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Proton beam therapy (PBT) is increasingly used to treat cancers, especially in the paediatric and adolescent and young adult (AYA) population. As PBT becomes more accessible, determining when PBT should be used instead of photon irradiation can be difficult. There is a need to balance patient, tumour and treatment factors when making this decision. Comparing the dosimetry between these two modalities plays an important role in this process. PBT can reduce low to intermediate doses to organs at risk (OAR), but photon irradiation has its dosimetric advantages. We present two cases with brain tumours, one paediatric and one AYA, in which treatment plan comparison between photons and protons showed dosimetric advantages of photon irradiation. The first case was an 18‐month‐old child diagnosed with posterior fossa ependymoma requiring adjuvant radiotherapy. Photon irradiation using volumetric modulated arc therapy (VMAT) had lower doses to the hippocampi but higher doses to the pituitary gland. The second case was a 21‐year‐old with an optic pathway glioma. There was better sparing of the critical optic structures and pituitary gland using fractionated stereotactic radiation therapy over PBT. The dosimetric advantages of photon irradiation over PBT have been demonstrated in these cases. This highlights the role of proton‐to‐photon comparative treatment planning to better understand which patients might benefit from photon irradiation versus PBT.

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The Pediatric Proton and Photon Therapy Comparison Cohort: Study Design for a Multicenter Retrospective Cohort to Investigate Subsequent Cancers After Pediatric Radiation Therapy

Cited by 6 publications

References 48 publications

Risk of second primary cancer from proton arc therapy of pediatric brain tumors

Risk of second primary cancer from proton arc therapy of pediatric brain tumors

Fluorescence In Situ Hybridization-Based Chromosome Aberration Analysis Unveils the Mechanistic Basis for Boron-Neutron Capture Therapy’s Radiobiological Effectiveness

Is proton beam therapy always better than photon irradiation? Lessons from two cases

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