scholarly journals Volumetric de‐escalation and improved acute toxicity with proton craniospinal irradiation using a vertebral body‐sparing technique

2021 ◽  
Author(s):  
Brian Chou ◽  
Austin Hopper ◽  
Jennifer Elster ◽  
John R. Crawford ◽  
Kristen McConnell ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Vertebral Body ◽  
Craniospinal Irradiation

scholarly journals Volumetric De-Escalation and Improved Acute Toxicity with Proton Craniospinal Irradiation Using a Vertebral Body Sparing Technique

2021 ◽  
Author(s):  
Brian Chou ◽  
Austin Hopper ◽  
Jennifer Elster ◽  
John Crawford ◽  
Kristen McConnell ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Vertebral Body ◽  
Disease Free Survival ◽  
Craniospinal Irradiation ◽  
Red Blood Cell Transfusion ◽  
Hematologic Toxicity ◽  
Exact Test ◽  
Rank Analysis ◽  
Kaplan Meier ◽  
Gi Toxicity

Purpose: Craniospinal irradiation (CSI) has historically treated the entire vertebral body (VB) in growing children. Vertebral body sparing proton craniospinal irradiation (VBSpCSI) is a technique which spares the majority of the VB from significant irradiation. This retrospective study reviews the acute toxicity of VBSpCSI compared to photon CSI. Methods: Pediatric CSI patients treated between 2008 and 2018 were evaluated. Patients were stratified to the VBSpCSI cohort or the photon cohort and analyzed for acute toxicity profile during treatment and disease-free survival (DFS). Statistical analysis was performed using Kaplan-Meier log rank analysis for DFS and Fisher’s exact test for toxicity. Results: Twenty-five patients received VBSpCSI and 13 patients received photon CSI. Mean patient age at treatment was 7.5y (range 2 to 16). The cohorts were well-matched with respect to gender, age, and CSI dose. Two-year DFS was similar between cohorts (81% VBSpCSI vs 61% photon, p=0.18). Patients receiving VBSpCSI had lower rates of grade 2+ GI toxicity (24% vs 76.5%, p=0.005), grade 2+ nausea (24% vs 61.5%, p=0.035), and any-grade esophagitis (0% vs 38%, p=0.0026). Patients treated with VBSpCSI had lower red blood cell transfusion rates (21.7% vs 60%, p=0.049) and grade 4+ lymphopenia (33.3% vs 77.8%, p=0.046). Conclusions: VBSpCSI in children is a volumetric de-escalation from traditional volumes which irradiate the entire vertebral body. Based on our results, VBSpCSI was associated with less acute gastrointestinal and hematologic toxicity. The study adds to the growing body of evidence supporting the use of protons over photons for pediatric CSI.

Normal tissue exposure and second malignancy risk in vertebral-body-sparing craniospinal irradiation

2022 ◽  
Author(s):  
Bailey Nelson ◽  
Michael Lamba ◽  
Steven Ewart ◽  
Nnamdi Ike ◽  
Luke Lewis ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Normal Tissue ◽  
Craniospinal Irradiation ◽  
Second Malignancy ◽  
Malignancy Risk

scholarly journals Effects of vertebral-body-sparing proton craniospinal irradiation on the spine of young pediatric patients with medulloblastoma

2017 ◽  
Vol 2 (2) ◽  
pp. 220-227 ◽  
Author(s):  
Iain MacEwan ◽  
Brian Chou ◽  
Jeremy Moretz ◽  
Lilia Loredo ◽  
David Bush ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Pediatric Patients ◽  
Craniospinal Irradiation

Vertebral Body Growth after Craniospinal Irradiation

2005 ◽  
Vol 63 ◽  
pp. S443
Author(s):  
K.A. Hartley ◽  
C. Li ◽  
F.H. Laningham ◽  
X. Xiong ◽  
T.E. Merchant
Keyword(s):  
Vertebral Body ◽  
Body Growth ◽  
Craniospinal Irradiation

Acute toxicity of craniospinal irradiation with volumetric-modulated arc therapy in children with solid tumors

2018 ◽  
Vol 65 (7) ◽  
pp. e27050 ◽  
Author(s):  
Kenneth K. Wong ◽  
Omar Ragab ◽  
Hung N. Tran ◽  
Anthony Pham ◽  
Sean All ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Solid Tumors ◽  
Volumetric Modulated Arc Therapy ◽  
Craniospinal Irradiation ◽  
Arc Therapy

scholarly journals Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma

2013 ◽  
Vol 86 (2) ◽  
pp. 277-284 ◽  
Author(s):  
Aaron P. Brown ◽  
Christian L. Barney ◽  
David R. Grosshans ◽  
Mary Frances McAleer ◽  
John F. de Groot ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Proton Beam ◽  
Craniospinal Irradiation
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