Suppr超能文献

儿童髓母细胞瘤质子治疗后的毒性反应及临床结果:一项多中心回顾性研究

Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study.

作者信息

Ruggi Alessandro, Melchionda Fraia, Sardi Iacopo, Pavone Rossana, Meneghello Linda, Kitanovski Lidija, Zaletel Lorna Zadravec, Farace Paolo, Zucchelli Mino, Scagnet Mirko, Toni Francesco, Righetto Roberto, Cianchetti Marco, Prete Arcangelo, Greto Daniela, Cammelli Silvia, Morganti Alessio Giuseppe, Rombi Barbara

机构信息

Specialty School of Paediatrics-Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy.

Pediatric Onco-Hematology, IRCCS Sant'Orsola SSD, University Hospital of Bologna, 40138 Bologna, Italy.

出版信息

Cancers (Basel). 2022 Jun 1;14(11):2747. doi: 10.3390/cancers14112747.

Abstract

Medulloblastoma is the most common malignant brain tumor in children. Even if current treatment dramatically improves the prognosis, survivors often develop long-term treatment-related sequelae. The current radiotherapy standard for medulloblastoma is craniospinal irradiation with a boost to the primary tumor site and to any metastatic sites. Proton therapy (PT) has similar efficacy compared to traditional photon-based radiotherapy but might achieve lower toxicity rates. We report on our multi-centric experience with 43 children with medulloblastoma (median age at diagnosis 8.7 years, IQR 6.6, M/F 23/20; 26 high-risk, 14 standard-risk, 3 ex-infant), who received active scanning PT between 2015 and 2021, with a focus on PT-related acute-subacute toxicity, as well as some preliminary data on late toxicity. Most acute toxicities were mild and manageable with supportive therapy. Hematological toxicity was limited, even among HR patients who underwent hematopoietic stem-cell transplantation before PT. Preliminary data on late sequelae were also encouraging, although a longer follow-up is needed.

摘要

髓母细胞瘤是儿童最常见的恶性脑肿瘤。即使目前的治疗方法显著改善了预后,幸存者仍常出现与治疗相关的长期后遗症。目前髓母细胞瘤的放疗标准是全脑全脊髓照射,并对原发肿瘤部位和任何转移部位进行强化照射。质子治疗(PT)与传统的基于光子的放疗相比具有相似的疗效,但可能具有更低的毒性率。我们报告了我们对43例髓母细胞瘤患儿(诊断时的中位年龄为8.7岁,四分位间距为6.6,男/女为23/20;26例高危,14例标准风险,3例曾为婴儿期患者)的多中心经验,这些患儿在2015年至2021年期间接受了主动扫描质子治疗,重点关注与质子治疗相关的急-亚急性毒性,以及一些关于迟发性毒性的初步数据。大多数急性毒性较轻,通过支持治疗可控制。血液学毒性有限,即使在质子治疗前接受过造血干细胞移植的高危患者中也是如此。关于迟发性后遗症的初步数据也令人鼓舞,不过仍需要更长时间的随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849a/9179586/04b5f7354b88/cancers-14-02747-g001a.jpg

相似文献

2
Successful Implementation of Image-Guided Pencil-Beam Scanning Proton Therapy in Medulloblastomas.
Diagnostics (Basel). 2023 Nov 3;13(21):3378. doi: 10.3390/diagnostics13213378.
3
Long-term toxic effects of proton radiotherapy for paediatric medulloblastoma: a phase 2 single-arm study.
Lancet Oncol. 2016 Mar;17(3):287-298. doi: 10.1016/S1470-2045(15)00167-9. Epub 2016 Jan 30.
4
Late toxicity following craniospinal radiation for early-stage medulloblastoma.
Acta Oncol. 2014 Apr;53(4):471-80. doi: 10.3109/0284186X.2013.862596. Epub 2014 Feb 24.
6
A Multi-institutional Comparative Analysis of Proton and Photon Therapy-Induced Hematologic Toxicity in Patients With Medulloblastoma.
Int J Radiat Oncol Biol Phys. 2021 Mar 1;109(3):726-735. doi: 10.1016/j.ijrobp.2020.09.049. Epub 2020 Nov 23.
8
Proton therapy for adult medulloblastoma: Acute toxicity and disease control outcomes.
J Neurooncol. 2021 Jul;153(3):467-476. doi: 10.1007/s11060-021-03783-x. Epub 2021 Jun 8.
9
The therapy of infantile malignant brain tumors: current status?
J Neurooncol. 2005 Dec;75(3):279-85. doi: 10.1007/s11060-005-6752-x.

引用本文的文献

2
Acute Toxicities of Proton Craniospinal Irradiation in Pediatric Medulloblastoma: A Pediatric Proton/Photon Consortium Registry (PPCR) Study.
Int J Part Ther. 2025 Apr 17;16:100747. doi: 10.1016/j.ijpt.2025.100747. eCollection 2025 Jun.
3
Pediatric CNS Radiation Oncology: Recent Developments and Novel Techniques.
Curr Oncol. 2025 Mar 20;32(3):180. doi: 10.3390/curroncol32030180.
4
Dynamics and predictors of hematologic toxicity during cranio-spinal irradiation.
Rep Pract Oncol Radiother. 2024 Jul 22;29(3):362-372. doi: 10.5603/rpor.101094. eCollection 2024.
5
Adolescents and Young Adults With Cancer: CNS Tumors.
J Clin Oncol. 2024 Feb 20;42(6):686-695. doi: 10.1200/JCO.23.01747. Epub 2023 Dec 8.
6
Setup Uncertainty of Pediatric Brain Tumor Patients Receiving Proton Therapy: A Prospective Study.
Cancers (Basel). 2023 Nov 20;15(22):5486. doi: 10.3390/cancers15225486.

本文引用的文献

1
Natural history and treatment options of radiation-induced brain cavernomas: a systematic review.
Neurosurg Rev. 2022 Feb;45(1):243-251. doi: 10.1007/s10143-021-01598-y. Epub 2021 Jul 4.
3
A Multi-institutional Comparative Analysis of Proton and Photon Therapy-Induced Hematologic Toxicity in Patients With Medulloblastoma.
Int J Radiat Oncol Biol Phys. 2021 Mar 1;109(3):726-735. doi: 10.1016/j.ijrobp.2020.09.049. Epub 2020 Nov 23.
4
Superior Intellectual Outcomes After Proton Radiotherapy Compared With Photon Radiotherapy for Pediatric Medulloblastoma.
J Clin Oncol. 2020 Feb 10;38(5):454-461. doi: 10.1200/JCO.19.01706. Epub 2019 Nov 27.
5
Radiation-induced vascular changes in the intracranial irradiation field in medulloblastoma survivors: An MRI study.
Radiother Oncol. 2019 Jul;136:50-55. doi: 10.1016/j.radonc.2019.03.017. Epub 2019 Apr 11.
6
An advanced junction concept in pediatric craniospinal irradiation by proton pencil beam scanning.
Phys Med. 2019 Apr;60:168-173. doi: 10.1016/j.ejmp.2019.04.002. Epub 2019 Apr 9.
7
Medulloblastoma.
Nat Rev Dis Primers. 2019 Feb 14;5(1):11. doi: 10.1038/s41572-019-0063-6.
8
Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma.
Int J Radiat Oncol Biol Phys. 2019 May 1;104(1):149-156. doi: 10.1016/j.ijrobp.2019.01.078. Epub 2019 Jan 23.
9
Radiotherapy Advances in Paediatric Medulloblastoma Treatment.
Clin Oncol (R Coll Radiol). 2019 Mar;31(3):171-181. doi: 10.1016/j.clon.2019.01.001. Epub 2019 Jan 14.
10
Patterns of proton therapy use in pediatric cancer management in 2016: An international survey.
Radiother Oncol. 2019 Mar;132:155-161. doi: 10.1016/j.radonc.2018.10.022. Epub 2018 Nov 7.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验