Proton beam therapy reduces the incidence of acute haematological and gastrointestinal toxicities associated with craniospinal irradiation in pediatric brain tumors

Authors

  • Sanghyuk Song Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Seoul, Korea; Department of Radiation Oncology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
  • Hyeon Jin Park Center for Pediatric Oncology, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Jong Hyung Yoon Center for Pediatric Oncology, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Dae Woong Kim Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Jeonghoon Park Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Dongho Shin Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Sang Hoon Shin Center for Pediatric Oncology, Research Institute and Hospital, National Cancer Center, Seoul, Korea
  • Hyoung Jin Kang Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
  • Seung-Ki Kim Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital of Medicine, Seoul, Korea
  • Ji Hoon Phi Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital of Medicine, Seoul, Korea
  • Joo-Young Kim Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Seoul, Korea; Center for Pediatric Oncology, Research Institute and Hospital, National Cancer Center, Seoul, Korea

DOI:

https://doi.org/10.3109/0284186X.2014.887225

Abstract

Background. The benefits of proton beam craniospinal irradiation (PrBCSI) in children have been extensively reported in dosimetric studies. However, there is limited clinical evidence supporting the use of PrBCSI. We compared the acute toxicity of PrBCSI relative to that of conventional photon beam CSI (PhBCSI) in children with brain tumours.

Material and methods. We prospectively evaluated the haematological and gastrointestinal toxicities in 30 patients who underwent PrBCSI between April 2008 and December 2012. As a reference group, we retrospectively evaluated the medical records of 13 patients who underwent PhBCSI between April 2003 and April 2012. The median follow-up time from starting CSI was 22 months (range 2–118 months). The mean irradiation dose was 32.1 Gy (range 23.4–39.6 Gy) and 29.4 CGE (cobalt grey equivalents; range 19.8–39.6), in the PrBCSI and PhBCSI groups, respectively (p = 0.236).

Results. There was no craniospinal fluid space relapse after curative therapy in either group of patients. Thrombocytopenia was less severe in the PrBCSI group than in the PhBCSI group (p = 0.012). The recovery rates of leukocyte and platelet counts measured one month after treatment were significantly greater in the PrBCSI group than in the PhBCSI group (p = 0.003 and p = 0.010, respectively). Diarrhoea was reported by 23% of patients in the PhBCSI group versus none in the PrBCSI group (p = 0.023).

Conclusions. The incidence rates of thrombocytopenia and diarrhoea were lower in the PrBCSI group than in the PhBCSI group. One month after completing treatment, the recovery from leukopenia and thrombocytopenia was better in patients treated with PrBCSI than in those treated with PhBCSI.

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Published

2014-09-01

How to Cite

Song, S., Jin Park, H., Hyung Yoon, J., Woong Kim, D., Park, J., Shin, D., … Kim, J.-Y. (2014). Proton beam therapy reduces the incidence of acute haematological and gastrointestinal toxicities associated with craniospinal irradiation in pediatric brain tumors. Acta Oncologica, 53(9), 1158–1164. https://doi.org/10.3109/0284186X.2014.887225

Issue

Vol. 53 No. 9 (2014): Acta Oncologica

Section

Articles