Proton Therapy in Children: A Systematic Review of Clinical Effectiveness in 15 Pediatric Cancers

Leroy, Roos; Benahmed, Nadia; Hulstaert, Frank; Damme, Nancy Van; Ruysscher, Dirk De

doi:10.1016/j.ijrobp.2015.10.025

Cited by 96 publications

(80 citation statements)

References 65 publications

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“…Most contemporary surgeons recommend a rational attempt at resection, with the goal of maximal safe tumor removal while minimizing morbidity [1,8]. Residual tumor is treated with subsequent radiation therapy, most commonly through proton beam [9].…”

Section: Discussionmentioning

confidence: 99%

Frontal burr hole approach for neuroendoscopic resection of craniopharyngioma with the NICO Myriad device: report of two cases

2017

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Section: Discussionmentioning

confidence: 99%

Frontal burr hole approach for neuroendoscopic resection of craniopharyngioma with the NICO Myriad device: report of two cases

2017

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“…While the observed results were also encouraging, further research is required before such techniques can be considered standard. A systematic review of clinical outcome studies published between 2007 and 2015 concludes that there is insufficient evidence on the long-term effectiveness and harm of protons to either support or refute their use in children with osteosarcoma or basically any other pediatric cancer 41 .…”

Section: Advances In Local Treatment Of Inoperable Osteosarcomasmentioning

confidence: 99%

Advances in the management of osteosarcoma

et al. 2016

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Osteosarcoma, a bone cancer most commonly seen in adolescents and young adults, is usually a high-grade malignancy characterized by a very high risk for the development of pulmonary metastases. High-grade osteosarcomas are usually treated by preoperative and postoperative chemotherapy and surgery, with a very limited number of active agents available. Rarer lower-grade variants such as parosteal and periosteal osteosarcoma or low-grade central osteosarcoma are treated by surgery only. Imaging to search for possible metastases focuses on the lung. Computed tomography is the most sensitive method but cannot reliably distinguish small metastases from benign lesions. Advances of local imaging and surgical reconstruction now allow the use of limb-salvage in an ever-increasing proportion of patients. While still troubled by complications, non-invasive endoprosthesis-lengthening mechanisms have led to an increased uptake of limb-salvage, even for young, skeletally immature patients. Radiotherapy is employed when osteosarcomas cannot be removed with clear margins, but very high doses are required, and both proton and carbon-ion radiotherapy are under investigation. Unfortunately, the past 30 years have witnessed few, if any, survival improvements. Novel agents have not led to universally accepted changes of treatment standards. In patients with operable high-grade osteosarcomas, the extent of histological response to preoperative chemotherapy is a significant predictive factor for both local and systemic control. Attempts to improve prognosis by adapting postoperative treatment to response, recently tested in a randomized, prospective setting by the European and American Osteosarcoma Study Group, have not been proven to be beneficial. Many agree that only increased knowledge about osteosarcoma biology will lead to novel, effective treatment approaches and will be able to move the field forward.

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“…Low LET radiation induces cell death mainly through indirect effects, such as the production of reactive oxygen species while high LET radiation causes irreparable DNA breaks that induce apoptosis. In a recent meta-analysis, Leroy and colleagues reviewed data from proton therapy from a total of 650 pediatric patients who had undergone proton therapy and found that the evidence was insufficient to conclude that proton therapy had any advantage in terms of effectiveness over photon therapy [63]. Another novel type of RT involves the use of carbon ions.…”

Section: Exposure From Treatment Modalitiesmentioning

confidence: 99%

Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations

Kutanzi

Lumen

Koturbash

et al. 2016

IJERPH

176

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Children are at a greater risk than adults of developing cancer after being exposed to ionizing radiation. Because of their developing bodies and long life expectancy post-exposure, children require specific attention in the aftermath of nuclear accidents and when radiation is used for diagnosis or treatment purposes. In this review, we discuss the carcinogenic potential of pediatric exposures to ionizing radiation from accidental, diagnostic, and therapeutic modalities. Particular emphasis is given to leukemia and thyroid cancers as consequences of accidental exposures. We further discuss the evidence of cancers that arise as a result of radiotherapy and conclude the review with a summary on the available literature on the links between computer tomography (CT) and carcinogenesis. Appropriate actions taken to mitigate or minimize the negative health effects of pediatric exposures to ionizing radiation and future considerations are discussed.

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Proton Therapy in Children: A Systematic Review of Clinical Effectiveness in 15 Pediatric Cancers

Cited by 96 publications

References 65 publications

Frontal burr hole approach for neuroendoscopic resection of craniopharyngioma with the NICO Myriad device: report of two cases

Frontal burr hole approach for neuroendoscopic resection of craniopharyngioma with the NICO Myriad device: report of two cases

Advances in the management of osteosarcoma

Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations

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