Spot-scanning proton therapy for malignant soft tissue tumors in childhood: First experiences at the Paul Scherrer Institute

Journal Article · Thu Feb 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.08.053· OSTI ID:20944693

Timmermann, Beate ^[1]; Schuck, Andreas ^[2]; Niggli, Felix ^[3]; Weiss, Markus ^[4]; Lomax, Antony Jonathan ^[1]; Pedroni, Eros ^[1]; Coray, Adolf ^[1]; Jermann, Martin ^[1]; Rutz, Hans Peter ^[1]; Goitein, Gudrun ^[1]

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1. Division of Radiation Medicine, Proton Therapy, Paul Scherrer Institut, Villigen (Switzerland)
2. Department of Radiation Oncology, University of Muenster, Muenster (Germany)
3. Department of Paediatric Oncology, University Children's Hospital, Zurich (Switzerland)
4. Department of Anaesthesia, University Children's Hospital, Zuerich (Switzerland)

Purpose: Radiotherapy plays a major role in the treatment strategy of childhood sarcomas. Consequences of treatment are likely to affect the survivor's quality of life significantly. We investigated the feasibility of spot-scanning proton therapy (PT) for soft tissue tumors in childhood. Methods and Materials: Sixteen children with soft tissue sarcomas were included. Median age at PT was 3.3 years. In 10 children the tumor histology was embryonal rhabdomyosarcoma. All tumors were located in the head or neck, parameningeal, or paraspinal, or pelvic region. In the majority of children, the tumor was initially unresectable (Intergroup Rhabdomyosarcoma Study [IRS] Group III in 75%). In 50% of children the tumors exceeded 5 cm. Fourteen children had chemotherapy before and during PT. Median total dose of radiotherapy was 50 cobalt Gray equivalent (CGE). All 16 children were treated with spot-scanning proton therapy at the Paul Scherrer Institute, and in 3 children the PT was intensity-modulated (IMPT). Results: After median follow-up of 1.5 years, local control was achieved in 12 children. Four children failed locally, 1 at the border of the radiation field and 3 within the field. All 4 children died of tumor recurrence. All 4 showed unfavorable characteristic either of site or histopathology of the tumor. Acute toxicity was low, with Grade 3 or 4 side effects according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria occurring in the bone marrow only. Conclusions: Proton therapy was feasible and well tolerated. Early local control rates are comparable to those being achieved after conventional radiotherapy. For investigations on late effect, longer follow-up is needed.

• OSTI ID: 20944693
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BONE MARROW
CHEMOTHERAPY
CHILDREN
COBALT 50
HEAD
HISTOLOGY
IRRADIATION
NECK
PROTON BEAMS
RADIATION DOSES
RADIOTHERAPY
SARCOMAS
SIDE EFFECTS
TOXICITY