Radiation Necrosis and White Matter Lesions in Pediatric Patients With Brain Tumors Treated With Pencil Beam Scanning Proton Therapy

International Journal of Radiation Oncology, Biology, Physics
Beat BojaxhiuDamien C Weber

Abstract

To assess the rate of radiation necrosis (RN) and white matter lesions (WMLs) in pediatric patients with primary brain tumors treated with pencil beam scanning (PBS) proton therapy (PT) with or without concomitant chemotherapy at the PSI. Between 1999 and 2015, 171 pediatric patients (age <18 years) were treated with PT. Median age at diagnosis was 3.3 years (range, 0.3-17.0 years), and the median delivered dose was 54 Gy (relative biological effectiveness) (range, 40.0-74.1 Gy). Radiation necrosis and WMLs were defined as a new area of abnormal signal intensity on T2-weighted images or increased signal intensity on T2-weighted images, and contrast enhancement on T1 occurring in the brain parenchyma included in the radiation treatment field, which did not demonstrate any abnormality before PT. Radiation necrosis and WMLs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The median follow-up period for the surviving patients was 49.8 months (range, 5.9-194.7 months). Twenty-nine patients (17%) developed RN at a median time of 5 months (range, 1-26 months), most of them (n = 17; 59%) being asymptomatic (grade 1). Grade 2, 4, and 5 toxicities occurred in 8, 2, and 2 patients, respectively. E...Continue Reading

Citations

May 9, 2019·The British Journal of Radiology·Damien C WeberAlessia Pica
Jun 5, 2020·Radiation Oncology·Andrew J Boria, Carlos J Perez-Torres
Sep 11, 2020·International Journal of Radiation Oncology, Biology, Physics·Andrzej NiemierkoHarald Paganetti
Jun 4, 2020·Aging and Disease·Giuseppe CollocaVincenzo Valentini
Aug 19, 2021·International Journal of Radiation Oncology, Biology, Physics·Harald Paganetti

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