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Author Notes:

Corresponding Author: Torunn Yock, 55 Fruit Street, Proton Center, Room 110, Boston, MA 02114, PH: 617 726-6876, Fax: 617 724-9532, Email: tyock@partners.org

The content are solely the responsibility of the authors and do necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Conflicts of interest: none

Subjects:

Research Funding:

Financial support: Funded in part by the National Cancer Institute, Award number P01CA021239, and the Federal Share of program income earned by Massachusetts General Hospital on C06 CA059267, Proton Therapy Research and Treatment Center.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Radiology, Nuclear Medicine & Medical Imaging
  • ADJUVANT CHEMOTHERAPY
  • PEDIATRIC-ONCOLOGY
  • INTERNATIONAL SOCIETY
  • PATTERNS
  • FAILURE
  • RADIOTHERAPY
  • IRRADIATION
  • TUMOR
  • BOOST
  • IMRT

Clinical Outcomes Among Children With Standard-Risk Medulloblastoma Treated With Proton and Photon Radiation Therapy: A Comparison of Disease Control and Overall Survival

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Journal Title:

International Journal of Radiation Oncology - Biology - Physics

Volume:

Volume 94, Number 1

Publisher:

, Pages 133-138

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Purpose: The purpose of this study was to compare long-term disease control and overall survival between children treated with proton and photon radiation therapy (RT) for standard-risk medulloblastoma. Methods and Materials: This multi-institution cohort study includes 88 children treated with chemotherapy and proton (n=45) or photon (n=43) RT between 2000 and 2009. Overall survival (OS), recurrence-free survival (RFS), and patterns of failure were compared between the 2 cohorts. Results: Median (range) age was 6 years old at diagnosis (3-21 years) for proton patients versus 8 years (3-19 years) for photon patients (P=.011). Cohorts were similar with respect to sex, histology, extent of surgical resection, craniospinal irradiation (CSI) RT dose, total RT dose, whether the RT boost was delivered to the posterior fossa (PF) or tumor bed (TB), time from surgery to RT start, or total duration of RT. RT consisted of a median (range) CSI dose of 23.4 Gy (18-27 Gy) and a boost of 30.6 Gy (27-37.8 Gy). Median follow-up time is 6.2 years (95% confidence interval [CI]: 5.1-6.6 years) for proton patients versus 7.0 years (95% CI: 5.8-8.9 years) for photon patients. There was no significant difference in RFS or OS between patients treated with proton versus photon RT; 6-year RFS was 78.8% versus 76.5% (P=.948) and 6-year OS was 82.0% versus 87.6%, respectively (P=.285). On multivariate analysis, there was a trend for longer RFS with females (P=.058) and higher CSI dose (P=.096) and for longer OS with females (P=.093). Patterns of failure were similar between the 2 cohorts (P=.908). Conclusions: Disease control with proton and photon radiation therapy appears equivalent for standard risk medulloblastoma.

Copyright information:

© 2016 Elsevier Inc.

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