The Children's Oncology Group Radiation Oncology Discipline: 15 Years of Contributions to the Treatment of Childhood Cancer

Breneman, John C.; Donaldson, Sarah S.; Constine, Louis S.; Merchant, Thomas E.; Marcus, Karen J.; Paulino, Arnold dela Cruz; Followill, David S; Mahajan, Anita; Laack, Nadia N.; Esiashvili, Natia; Haas‐Kogan, Daphne A.; Laurie, Fran; Olch, Arthur J.; Ulin, Kenneth; Hodgson, David C.; Yock, Torunn I.; Terezakis, Stephanie A.; Krasin, Matt; Panoff, Joseph; Chuba, Paul J.; Hua, C.; Hess, Clayton B.; Houghton, Peter J.; Wolden, Suzanne L.; Buchsbaum, J.; Fitzgerald, Thomas J.; Kalapurakal, John A.

doi:10.1016/j.ijrobp.2018.03.002

Cited by 41 publications

(38 citation statements)

References 98 publications

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“…Radiation therapy is important in the treatment of pediatric malignancies including medulloblastoma, ependymoma, and glioma 3 . Immobilization of patients during radiation therapy is critical for precision targeting of tumors, especially central nervous system tumors 4 .…”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis to immobilization mask used in radiation therapy

Haddock

Barrio

2020

Pediatric Dermatology

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A 9-year-old male patient with medulloblastoma underwent surgical resection of the tumor and then began adjuvant treatment with proton beam therapy to his occiput and spine 5 days a week, as well as weekly vincristine infusions. During each proton beam therapy session, a custom-molded thermoplastic mask made of polyester resin was placed over the patient's face and neck and bolted to the treatment table to immobilize him (Figure 1). Fifteen days after initiating proton beam therapy, the patient developed a pruritic, erythematous, edematous rash that started on his ears and neck and spread to involve his cheeks and forehead (Figure 2A,B). The rash was sharply demarcated on the face and anterior neck and did not involve the scalp, back, or any other areas of the body. It was non-tender and minimally responsive to antihistamines. The rash flared after each proton beam therapy session. The rash raised concern for radiation dermatitis or ACD. However, radiation dermatitis was ruled out because the rash spared the occiput and spine, which were directly irradiated, and was limited to the areas of the face and neck that contacted the thermoplastic mask during treatment. A clinical diagnosis of ACD to the thermoplastic mask was made. The thermoplastic mask used during the patient's radiation therapy was a KLARITY GREEN™ mask (RG-BHM-3242, Klarity Medical Products, LLC, Heath, OH) made primarily of cured

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Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis to immobilization mask used in radiation therapy

Haddock

Barrio

2020

Pediatric Dermatology

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“…CT scan of the patient from the skull vertex to coccyx in supine position using immobilization device on Somatom Scope 32 slice multislice CT scanner (Siemens Shenghai Medical Equipment Limited, China) was done with 3-mm slice thickness. CT images were analyzed for contouring on SomaVision workstation (Varian Medical Systems, Inc., Palo Alto, CA, USA) where the target volumes (PTV Brain, PTV Spine) and normal structures were delineated by radiation oncologist as per the recommended guidelines of ICRU62 and Children's Oncology Group [10][11][12].…”

Section: Patient Characteristics and Ct Simulationmentioning

confidence: 99%

Evaluation of Dosimetric Parameters for Adolescent Craniospinal Irradiation

Verma¹,

Jain²,

Chougule³

2020

IJAR

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Background: Craniospinal irradiation (CSI) is an important and challenging radiotherapy technique used for the treatment of Medulloblastoma, one of the most common pediatric cancers. Pediatric patients present with wide variability in weight, height, spine length, brain diameter, body size, intra and inter fractional motion depending on their age as compared to adults. These parameters have significant impact on radiation dose delivery to target and normal structures during radiotherapy of pediatric cancer patients. The present study was aimed to evaluate dosimetric parameters and generate plan quality indices for adolescent CSI. Materials and Methods: A 17 years old male adolescent patient with Medulloblastoma was recruited in the present sturdy. The patient was planned with RapidArc TM / Volumetric Modulated Arc Therapy (VMAT) mode using 6 MV X-Ray photon beam from Varian Trilogy with FFF machine. The dose points such as max, mean, 2%, 98%, 95%, 105% and 107% were collected using dose statistics and dose volume histogram (DVH) and analyzed for calculation of various dosimetric parameters. The in-vivo dosimetry was performed and radiation doses to eyes were assessed using CaSO4:Dy TLD powder. Results: The plans were approved with a gamma passing rate (3%, 3mm) of more than 95%. The dose homogeneity index and conformity index were observed 0.074 and 1.10 respectively. The average doses to eyes were observed approximately 35% of the tumor dose during RapidArc TM-CSI. The results of the present study demonstrated that V5 was observed high the normal structures except kidneys. Esophagus and thyroid were receiving significant low dose spillage at a cost of high homogeneity and conformity of dose to PTV which were needed to enhance tumor control probability (TCP) of Medulloblastoma. Conclusion: The present study developed a benchmark guide for adolescent RapidArc TM-CSI.

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“…Furthermore, nephron sparing surgery has been strongly advocated by the Children's Oncology Group (19,20). The group supports its use in cases of unilateral Wilms tumor (<4 cm) where renal failure is imminent and/or when the onset of Wilms tumor begins in the unaffected kidney (19).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Nephron Sparing Surgery and Radical Nephrectomy in the Management of Unilateral Wilms Tumor: A Meta-Analysis

2020

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Background: Unilateral Wilms tumor is the most common renal malignancy in the pediatric population. Although the onset of surgical intervention like radical nephrectomy has substantially reduced the mortality rate, recent evidence has raised concerns regarding several postoperative complications associated with this procedure. Nephron sparing surgery has been reported to avoid such postoperative complications and have high technical success rate. However, no attempt to date has been made to synthesize the evidence comparing the efficacy of radical nephrectomy and nephron sparing surgery for managing unilateral Wilms tumor. Methods and Results: To metastatistically compare the efficiency of radical nephrectomy with nephron sparing surgery for managing unilateral Wilms tumor, a systematic identification of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines on four academic databases: MEDLINE, Scopus, EMBASE, and CENTRAL. A meta-analysis comparing renal function (estimated glomerular filtration rate), survival rate, and rate of relapse was performed to compare the efficacy of radical nephrectomy and nephron sparing surgery. Out of 1,283 records, 20 articles including 5,246 children (mean age, 4.3 ± 3.0 years) were included in this review. Radical nephrectomy was performed on 11 of the included studies, whereas nephron sparing surgery was performed on five studies. Two studies compared the efficacy of both interventions. The meta-analysis reveals the beneficial effects of nephron sparing surgery (Hedge's g, 0.76) as compared to radical nephrectomy (−0.16) for the estimated glomerular filtration rate for children with unilateral Wilms tumor. Moreover, higher survivability (0.59) and lesser occurrence of relapse were (−1.0) also reported for cases operated with nephron sparing surgery. Conclusion: The current meta-analysis recommends the use of nephron sparing surgery for unilateral Wilms tumor. The procedure accounts for higher survivability and postoperative renal function and lesser incidence of relapse as compared to radical nephrectomy.

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The Children's Oncology Group Radiation Oncology Discipline: 15 Years of Contributions to the Treatment of Childhood Cancer

Cited by 41 publications

References 98 publications

Allergic contact dermatitis to immobilization mask used in radiation therapy

Allergic contact dermatitis to immobilization mask used in radiation therapy

Evaluation of Dosimetric Parameters for Adolescent Craniospinal Irradiation

Effectiveness of Nephron Sparing Surgery and Radical Nephrectomy in the Management of Unilateral Wilms Tumor: A Meta-Analysis

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