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Clinical outcomes following proton therapy for children with central nervous system tumors referred overseas
Author(s) -
Indelicato Daniel J.,
Bradley Julie A.,
Sandler Eric S.,
Aldana Philipp R.,
Sapp Amy,
Gains Jennifer E.,
Crellin Adrian,
Rotondo Ronny L.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26654
Subject(s) - medicine , proton therapy , central nervous system , pediatrics , intensive care medicine , oncology , radiation therapy
Abstract Background International, multidisciplinary care of children with central nervous system (CNS) tumors presents unique challenges. The aim of this study is to report patient outcomes of U.K. children referred for proton therapy to a North American facility. Methods From 2008 to 2016, 166 U.K. children with approved CNS tumors were treated with proton therapy at a single academic medical center in the United States. Median age was 7 years (range, 1–19). Median follow‐up was 2.6 years. Results The 3‐year actuarial overall survival (OS) and local control (LC) rates were 96% and 91%, respectively, for the overall group, 92% and 85% for the ependymoma subgroup (n = 57), 95% and 88% for the low‐grade glioma subgroup (n = 54), and 100% and 100%, respectively, for the craniopharyngioma subgroup (n = 45). Cyst expansion was observed in 13 patients, including one case resulting in visual impairment. Serious side effects included new‐onset seizures in three patients (1.8%), symptomatic vasculopathy in three patients (1.8%), and symptomatic brainstem necrosis in one patient (0.6%). Conclusions In this cohort of British children referred overseas for proton therapy, disease control does not appear compromised, toxicity is acceptable, and improvement in long‐term function is anticipated in survivors owing to the reduced brain exposure afforded by proton therapy.