Proton Radiotherapy for Pediatric Central Nervous System Germ Cell Tumors: Early Clinical Outcomes

Journal Article · Sat Jan 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.10.069· OSTI ID:21491546

Trofimov, Alexei; Safai, Sairos; Adams, Judith; Fullerton, Barbara; Ebb, David; Tarbell, Nancy J; Yock, Torunn I ^[1]

---

1. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)

Purpose: To report early clinical outcomes for children with central nervous system (CNS) germ cell tumors treated with protons; to compare dose distributions for intensity-modulated photon radiotherapy (IMRT), three-dimensional conformal proton radiation (3D-CPT), and intensity-modulated proton therapy with pencil beam scanning (IMPT) for whole-ventricular irradiation with and without an involved-field boost. Methods and Materials: All children with CNS germinoma or nongerminomatous germ cell tumor who received treatment at the Massachusetts General Hospital between 1998 and 2007 were included in this study. The IMRT, 3D-CPT, and IMPT plans were generated and compared for a representative case. Results: Twenty-two patients were treated with 3D-CPT. At a median follow-up of 28 months, there were no CNS recurrences; 1 patient had a recurrence outside the CNS. Local control, progression-free survival, and overall survival rates were 100%, 95%, and 100%, respectively. Comparable tumor volume coverage was achieved with IMRT, 3D-CPT, and IMPT. Substantial normal tissue sparing was seen with any form of proton therapy as compared with IMRT. The use of IMPT may yield additional sparing of the brain and temporal lobes. Conclusions: Preliminary disease control with proton therapy compares favorably to the literature. Dosimetric comparisons demonstrate the advantage of proton radiation over IMRT for whole-ventricle radiation. Superior dose distributions were accomplished with fewer beam angles utilizing 3D-CPT and scanned protons. Intensity-modulated proton therapy with pencil beam scanning may improve dose distribution as compared with 3D-CPT for this treatment.

• OSTI ID: 21491546
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.10.069; PII: S0360-3016(09)03557-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
CHILDREN
COMPARATIVE EVALUATIONS
GERM CELLS
NEOPLASMS
PHOTONS
PROTONS
RADIATION DOSE DISTRIBUTIONS
RADIOTHERAPY
THREE-DIMENSIONAL CALCULATIONS
AGE GROUPS
ANIMALS
BARYONS
BODY
BOSONS
CENTRAL NERVOUS SYSTEM
DISEASES
ELEMENTARY PARTICLES
EVALUATION
FERMIONS
HADRONS
MAMMALS
MAN
MASSLESS PARTICLES
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEONS
ORGANS
PRIMATES
RADIOLOGY
THERAPY
VERTEBRATES