Journal: Pediatric Blood & Cancer

Abbreviation

Pediatr Blood Cancer.

Publisher

Wiley

Journal Volumes

ISSN

1545-5017
1545-5009

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2017 - 201912020 - 20252
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Publications 1 - 3 of 3
  • Outcomes of adolescents and young adults treated for brain and skull base tumors with pencil beam scanning proton therapy
    Item type: Journal Article
    Lim, Pei S.; Tran, Sebastien; Kroeze, Stephanie G. C.; et al. (2020)
    Pediatric Blood & Cancer
    Background The use of proton therapy (PT) in adolescents and young adults (AYAs) is becoming increasingly popular. This study aims to assess the outcomes and late toxicity consequences in AYAs (15-39 years) with brain/skull base tumors treated with pencil beam scanning proton therapy. Methods One hundred seventy six AYAs treated curatively at the Paul Scherrer Institute (PSI) were identified. Median age was 30 years (range 15-39) and median prescribed dose was 70.0 Gy (relative biological effectiveness [RBE]) (range 50.4-76.0). The most common tumors treated were chordomas/chondrosarcomas (61.4%), followed by gliomas (15.3%), and meningiomas (14.2%). Results After a median follow up of 66 months (range 12-236), 24 (13.6%) local only failures and one (0.6%) central nervous system (CNS) distant only failure were observed. The 6-year local control, distant progression-free survival, and overall survival were 83.2%, 97.4%, and 90.2%, respectively. The 6-year high-grade (>= grade [G] 3) PT-related late toxicity-free survival was 88.5%. Crude late toxicity rates were 26.2% G1, 37.8% G2, 12.2% G3, 0.6% G4, and 0.6% G5. The one G4 toxicity was a retinopathy and one G5 toxicity was a brainstem hemorrhage. The 6-year cumulative incidences for any late PT-related pituitary, ototoxicity, and neurotoxicity were 36.3%, 18.3%, and 25.6%; whilst high-grade (>= G3) ototoxicity and neurotoxicity were 3.4% and 2.9%, respectively. No secondary malignancies were observed. The rate of unemployment was 9.5% pre-PT, increasing to 23.8% post-PT. Sixty-two percent of survivors were working whilst 12.7% were in education post-PT. Conclusions PT is an effective treatment for brain/skull base tumors in the AYA population with a reasonable late toxicity profile. Despite good clinical outcomes, around one in four AYA survivors are unemployed after treatment.
  • Long-Term Clinical Outcome and Quality of Life of Children, Adolescents, and Young Adults With Chordoma or Chondrosarcoma Treated With Pencil Beam Scanning Proton Therapy
    Item type: Journal Article
    Vazquez, Miriam; Cherchik, Alexey; de Angelis, Claudio; et al. (2025)
    Pediatric Blood & Cancer
    Background and Aims: To assess clinical outcomes and quality of life (QoL) of children, adolescents, and young adults (C-AYAs) with chordomas (CH) or chondrosarcomas (CS) after pencil beam scanning proton therapy (pbsPT). Methods: A total of 76 C-AYAs treated between 1999 and 2023 were included. Median age was 16.6 years (1.5–25.4). A total of 44 (57.9%) were AYAs (15–25 years). Most tumors were CHs (n = 49; 64.5%) and located in the skull base (68.4%). Median radiation dose was 73.8 Gy (RBE) (54–75.6). A total of 26 (34.2%) patients underwent complete resection. PEDQOL questionnaire was used to assess QoL. Kaplan–Meier and log-rank tests were used for the analysis. Results: With a median follow-up of 88.4 months (range, 1.8–257.6), 9 (11.8%) patients died. Local failure only developed in 9 (11.8%) patients. Two (2.6%) presented with distant failure only and another (1.3%) had both. Seven-years overall survival (OS), local control (LC), and distant control (DC) were 86.3%, 87.7%, and 95.7%, respectively. Children when compared to AYAs had worse 7-years DC (90% vs. 100%, p = 0.049). Surgical resection vs. biopsy was associated with better 7-years LC (87.1% vs. 67.7%, p = 0.031). Recurrent tumors showed worse OS, LC, and DC (94.5% vs. 44.6%, p < 0.001; 93.2% vs. 36.6%, p < 0.001; 98.3% vs. 77.6%, p = 0.003). Seven-years freedom from grade ≥3 late toxicity was 83.1%. Three (3.9%) children with CH developed secondary tumors. QoL did not differ from a healthy cohort 2 years after pbsPT. Conclusions: Excellent clinical outcomes with acceptable long-term toxicity and QoL were observed for C-AYAs with CH/CS after pbsPT. Recurrent tumors, young age, and lack of surgical resection were associated with worse prognosis.
  • Pencil beam scanned protons for the treatment of patients with Ewing sarcoma
    Item type: Journal Article
    Weber, Damien C.; Murray, Fritz R.; Correia, Dora; et al. (2017)
    Pediatric Blood & Cancer
Publications 1 - 3 of 3