Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX, USA.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Pediatr Blood Cancer. 2023 Jan;70(1):e29981. doi: 10.1002/pbc.29981. Epub 2022 Sep 21.
The purpose of this study is to analyze renal function outcomes in abdominal neuroblastoma patients undergoing proton therapy (PT).
From 2011 to 2019, two single-institution Institutional Review Board-approved protocols prospectively enrolled neuroblastoma patients for data collection. To assess renal function, serum creatinine (Cr), blood urea nitrogen (BUN), and creatinine clearance (CrCl) before proton therapy (pre-PT) were compared with the values at last follow-up.
A total of 30 children with abdominal neuroblastoma with median age 3.5 years (range, 0.9-9.1) at time of PT were included in this study. All patients underwent chemotherapy and resection of primary tumor prior to PT. Two patients required radical nephrectomy. Median follow-up after PT was 35 months. Mean dose to ipsilateral and contralateral kidney was 13.9 and 5.4 Gy, respectively. No patients developed hypertension or renal dysfunction during follow-up. There was no statistically significant change in serum BUN (p = .508), CrCl (p = .280), or eGFR (p = .246) between pre-PT and last follow-up.
At a median follow-up of almost 3 years, renal toxicity was uncommon after PT. Longer follow-up and larger patient cohort data are needed to further assess impact of PT on renal function in this population.
本研究旨在分析接受质子治疗(PT)的腹部神经母细胞瘤患者的肾功能结果。
2011 年至 2019 年,两个单机构机构审查委员会批准的方案前瞻性地招募神经母细胞瘤患者进行数据收集。为了评估肾功能,将质子治疗前(pre-PT)的血清肌酐(Cr)、血尿素氮(BUN)和肌酐清除率(CrCl)与最后一次随访时的值进行比较。
本研究共纳入 30 例患有腹部神经母细胞瘤的儿童,中位年龄为 3.5 岁(范围,0.9-9.1),在接受 PT 时。所有患者在 PT 前均接受了化疗和原发肿瘤切除术。有 2 例患者需要根治性肾切除术。PT 后中位随访时间为 35 个月。同侧和对侧肾脏的平均剂量分别为 13.9 和 5.4 Gy。在随访期间,没有患者发生高血压或肾功能障碍。血清 BUN(p =.508)、CrCl(p =.280)或 eGFR(p =.246)在 pre-PT 和最后一次随访时均无统计学显著变化。
在中位随访近 3 年时,PT 后肾毒性并不常见。需要更长时间的随访和更大的患者队列数据来进一步评估 PT 对该人群肾功能的影响。