Proton therapy for pediatric head and neck malignancies

Vogel, Jennifer; Both, Stefan; Kirk, Maura; Chao, Hann Hsiang; Bagatell, Rochelle; Li, Yimei; Womer, Richard B.; Balamuth, Naomi; Reilly, Anne; Kurtz, Goldie; Lustig, Robert A.; Tochner, Zelig; Hill‐Kayser, Christine

doi:10.1002/pbc.26858

Cited by 28 publications

(18 citation statements)

References 41 publications

(76 reference statements)

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“…Another recent study investigated acute toxicities and early outcomes following PRT for pediatric head and neck malignancies. 26 That study concluded that PRT appears safe for this patient population, with LC rates similar to historical reports. However, due to limited follow-up time and cases, most studies are unable to provide sound data on long-term treatment-related side effects, such as growth and development impairment and secondary malignancies.…”

Section: Discussionsupporting

confidence: 65%

“…After a median five‐year follow‐up time, the five‐year failure‐free survival estimate was 59% (95% confidence interval, 33%–79%), and the OS estimate was 64% (95% confidence interval, 37%–82%), which is comparable with that in historical controls. Another recent study investigated acute toxicities and early outcomes following PRT for pediatric head and neck malignancies . That study concluded that PRT appears safe for this patient population, with LC rates similar to historical reports.…”

Section: Discussionmentioning

confidence: 99%

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¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

Chen

et al. 2019

Pediatric Blood & Cancer

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Background The purpose of this study was to present our preliminary assessment of the safety and efficacy of 125I interstitial brachytherapy (IBT) in the management of pediatric skull base tumors. Methods Thirty pediatric patients with skull base tumors treated with 125I IBT from April 2007 to May 2017 were included in this study. The probabilities of local control (LC) and overall survival (OS) were calculated by the Kaplan–Meier method. Results The one‐ and two‐year LC rates were 96.7% and 74.8%, respectively. The one‐ and two‐year OS rates were 93.3% and 72.2%, respectively. No severe acute toxicity was observed. Severe late toxicities were observed in one (3.33%) of 30 patients. Conclusion 125I IBT is effective and safe in the management of pediatric skull base tumors, with satisfactory cosmetic and functional outcomes.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

Chen

et al. 2019

Pediatric Blood & Cancer

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“…18 A study by Vogel et al at the University of Pennsylvania treating 69 pediatric and AYA patients with primary jaw tumors found that proton beam therapy was associated with reduced acute toxicity, favorable local control, and improved OS rates, although further surveillance is needed to monitor for late effects and to evaluate local control outcomes. 5…”

Section: The Role Of Systemic Therapy In Oral Maxillofacial Tumorsmentioning

confidence: 99%

“…Morbidities include dermatitis with subsequent feeding intolerance, infection, craniofacial and dental anomalies, cataracts, neuroendocrine defects, and neurocognitive delays. 5 In addition, as a consequence of either systemic chemotherapy or radiation therapy, these patients are at increased risk for secondary malignancies. These short-and long-term morbidities present challenges when balanced against effective treatment of the patient's disease.…”

Section: Introductionmentioning

confidence: 99%

Adolescent and Young Adult Oral Maxillofacial Tumors: A Single-Institution Case Series and Literature Review

George

Markiewicz

Garzon

et al. 2020

Journal of Adolescent and Young Adult Oncology

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Adolescent and young adult (AYA) oral maxillofacial tumors are rare and account for *12% of all AYA cancers. Due to the low incidence of these malignancies, diagnostic considerations, therapeutic approaches, and factors affecting prognosis have been difficult to characterize. Given the anatomic structures located within the head and neck, patients are at risk for treatment-related morbidity that may adversely impact their quality of life. We present a single-institution case series of AYA patients with oral maxillofacial tumors treated at the University of Illinois at Chicago. A multidisciplinary treatment approach, including collaboration with the Oral Maxillofacial Surgery, Dentistry, and the Ear, Nose, and Throat teams along with the utilization of Children's Oncology Group treatment protocols, can serve as a model to address the challenges in the management of these complex cases.

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“…The high-dose deposition at the distal end followed by a steep decline as well as minimal lateral scattering allows superior tissue sparing and a dose reduction outside the planned margin [5]. The reduced volume of healthy tissue exposed to intermediate and low doses suggests a reduced risk of secondary malignancies accompanied by a reduced co-irradiation of dose-limiting organs-at-risk such as brain stem, spinal cord, oral cavity, or the optic nerve [6,7]. Hence, current treatment decisions for particle beam therapy are primarily based on vulnerable tumor locations near organs-at-risk, and treated entities comprise uveal melanoma, skull-based and intracranial tumors, prostate and head and neck tumors [8,9].…”

Section: Introductionmentioning

confidence: 99%

Combined Treatment Modalities for High-Energy Proton Irradiation: Exploiting Specific DNA Repair Dependencies

Deycmar

Pruschy

2018

International Journal of Particle Therapy

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DNA repair deficiencies and genome instability are common features and hallmarks of cancer and are ubiquitously found in the full spectrum of malignant diseases. Heritable DNA repair deficiencies, for example, due to BRCA1 and BRCA2 mutations, and subsequent loss of heterozygosity in mammary, ovarian, and prostate carcinoma, are risk factors for the early development of cancer. Despite their detrimental role in tumorigenesis, these deficiencies also provide novel opportunities for treatment options. Current and future pharmacologic approaches in medical oncology rely on the exploitation of such genetically defined, tumor-specific Achilles' heels and integrate the genetic background of a tumor into the treatment strategy. For example, homologous recombination-corrupted, BRCA1/2-mutated tumors are becoming hypersensitive to inhibitors of an additional DNA-damage-repair mechanism and are successfully treated with respective molecular targeting agents such as PARP1 inhibitors. Patient stratification in radiation oncology today is primarily based on clinical parameters and uses highly sophisticated diagnostic imaging for treatment planning on the individual level. Radiation oncology only minimally takes the genetic makeup of tumors into account, and little attention has been given to the fact that the different modalities of ionizing radiation, such as photon and proton irradiation, may also induce differential damages and biological processes, which might again be influenced by the genetic makeup and mutational status of the tumor. However, radiation oncology is nowadays challenged to understand subtle differences induced by the different qualities of ionizing radiation, and to efficiently exploit and to integrate these differential responses in a personalized treatment approach alone and as part of combined treatment modalities with pharmacologic agents. Here we will review recent insights on the differential DNA damage responses to photon and proton irradiation and discuss their implications for combined treatment modalities with chemotherapeutical agents and small molecular targeting compounds.

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Proton therapy for pediatric head and neck malignancies

Cited by 28 publications

References 41 publications

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

Adolescent and Young Adult Oral Maxillofacial Tumors: A Single-Institution Case Series and Literature Review

Combined Treatment Modalities for High-Energy Proton Irradiation: Exploiting Specific DNA Repair Dependencies

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Proton therapy for pediatric head and neck malignancies

Cited by 28 publications

References 41 publications

125I interstitial brachytherapy in management of pediatric skull base tumors

125I interstitial brachytherapy in management of pediatric skull base tumors

Adolescent and Young Adult Oral Maxillofacial Tumors: A Single-Institution Case Series and Literature Review

Combined Treatment Modalities for High-Energy Proton Irradiation: Exploiting Specific DNA Repair Dependencies

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¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors