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