Preliminary Results of a Phase II Trial of Proton Radiotherapy for Pediatric Rhabdomyosarcoma

Abstract

Five-year LC, EFS, and OS rates were similar to those observed in comparable trials that used photon radiation. Acute and late toxicity rates were favorable. Proton radiation appears to represent a safe and effective radiation modality for pediatric RMS.

Late Toxicities of Intensity Modulated Radiation Therapy for Head and Neck Rhabdomyosarcoma

“…[11] Ladra et al reported no secondary malignancies in the phase II trial of proton radiotherapy for pediatric rhabdomyosarcoma with median follow-up of 3.9 years. [6] For all of these studies, including the present report, longer follow-up is needed to better assess the risk of secondary solid cancers after radiotherapy.…”

“…[9] The late toxicities of 43 patients with any tumor site enrolled in this phase II trial have been reported by Ladra et al and include: grade 3 late toxicities, including cataract, chronic otitis, and retinopathy with decreased visual acuity, in 7% of patients; grade 2 late toxicities, including dry eye, facial asymmetry, epistaxis, dry skin, chronic otitis, endocrine abnormalities, hearing loss, and cognitive disturbance, in 20% of patients. [6] For 39 pediatric patients with parameningeal rhabdomyosarcoma treated with pencil beam scanning proton radiotherapy, Weber et al reported grade 1 late toxicities in 21% of patients, grade 2 late toxicities in 26% of patients, and grade 3 late toxicities in 8% of patients with no secondary malignancies at median follow-up of 3.4 months. Grade 3 toxicities included cataract and hearing loss.…”

“…[4] In an effort to reduce radiation doses to normal tissue, and thereby minimize the acute and long-term toxicity of radiotherapy, radiation techniques for patients with head and neck rhabdomyosarcoma have significantly evolved over the past 20 years from three-dimensional (3D) conformal planning to IMRT and also proton radiotherapy. [4][5][6][7] While Paulino et al…”

“…[4,6,[8][9][10][11][12] The objective of the current report is to fill this gap by delineating the late effects of IMRT in a single-institutional cohort of pediatric patients with rhabdomyosarcoma of the head and neck.…”

Proton radiotherapy should be further developed in Poland

“…Indications on using proton radiotherapy for cases of highly differentiated gliomas should be established, given that they are the most commonly diagnosed brain tumours in children and thus constitute the most common cause for employing brain radiotherapy to this age group [17]. The value-added benefit of proton beam radiotherapy is also increased when cases of soft tissue sarcoma [25], chordoma and chondrosarcoma [26] and retinoblastoma [27] are diagnosed.…”