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Cancers 2015, 7(2), 706-722; doi:10.3390/cancers7020706

Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT

1,†,* and 2,†
1
Department of Radiotherapy Physics, Royal Derby Hospital, Derby Hospitals NHS Foundation Trust, Uttoxeter Road, Derby DE22 3NE, UK
2
The Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, Wirral CH63 4JY, UK
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Xiaodong Zhang
Received: 2 January 2015 / Revised: 16 April 2015 / Accepted: 20 April 2015 / Published: 28 April 2015
(This article belongs to the Special Issue Proton Therapy for Cancer)
View Full-Text   |   Download PDF [176 KB, uploaded 28 April 2015]

Abstract

Background: We compare clinical outcomes of paediatric patients with CNS tumours treated with protons or IMRT. CNS tumours form the second most common group of cancers in children. Radiotherapy plays a major role in the treatment of many of these patients but also contributes to late side effects in long term survivors. Radiation dose inevitably deposited in healthy tissues outside the clinical target has been linked to detrimental late effects such as neurocognitive, behavioural and vascular effects in addition to endocrine abnormalities and second tumours. Methods: A literature search was performed using keywords: protons, IMRT, CNS and paediatric. Of 189 papers retrieved, 10 were deemed relevant based on title and abstract screening. All papers directly compared outcomes from protons with photons, five papers included medulloblastoma, four papers each included craniopharyngioma and low grade gliomas and three papers included ependymoma. Results: This review found that while proton beam therapy offered similar clinical target coverage, there was a demonstrable reduction in integral dose to normal structures. Conclusions: This in turn suggests the potential for superior long term outcomes for paediatric patients with CNS tumours both in terms of radiogenic second cancers and out-of-field adverse effects. View Full-Text
Keywords: proton therapy; IMRT; paediatric; CNS; medulloblastoma; cranio-pharyngioma; low grade glioma; ependymoma proton therapy; IMRT; paediatric; CNS; medulloblastoma; cranio-pharyngioma; low grade glioma; ependymoma
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Armoogum, K.S.; Thorp, N. Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT. Cancers 2015, 7, 706-722.

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