Proton therapy for pediatric tumors

Proton therapy for pediatric tumors

Proton therapy for pediatric tumors

The largest consensus on the preferability of proton over conventional radiotherapy is in the field of pediatric oncology. Given a 70-80% survival rate, finding forms of radiation therapy that positively impact on quality of life outcomes has increasingly become a focal point among pediatric oncologists. Clinical outcome data presented in the white paper show that proton therapy provides an effective means to achieve this end.

Benefits of proton therapy for pediatric cancers

Pediatric cancer patients survival has increased from about 30% in the late 1960s to 70-80% today. Given the better chances of a cure, the reduction of acute and late complications in particular has become a major focus when it comes to improving available therapies. As there is no exit dose with proton radiation therapy, the dose directed into surrounding normal healthy tissues is significantly limited, reducing the acute toxicity. This ultimately reduces the risk of developing long-term side effects. Article reference is available in the white paper.

Reference to ongoing studies

Ethical concerns deter many experts from performing Phase III randomized studies of protons versus photons in childhood malignancies. However, no less than twelve studies are currently being conducted across the United States. Article reference is available in the white paper.

The expert's perspective

Dr Indelicato is the Associate Professor of the Department of Radiation Oncology at the University of Florida. He directs the University of Florida pediatric proton program, currently the largest program of its kind in the world. When asked about proton therapy's role in pediatrics today, Dr Indelicato answered: "In some tumors, it allows us to improve the cure rate through dose escalation, while in other cases the clinical benefits lie in the reduced radiation toxicity. About the future, Dr Indelicato states that:"CT and MRI based image guidance are imminent and will bring proton therapy on par with image guidance on linear accelerators. Proton delivery will become increasingly efficient".

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Reduction in dose to critical structures

In their 2014 article, 'Craniopharyngioma and Proton Therapy', Bradley et al. collated the available data and found dosimetric studies that suggested that for patients with craniopharyngioma, proton therapy affords a reduction in dose to critical structures when compared to conventional photon radiation, including IMRT.

*Sejpal, S. “Early findings on toxicity of proton beam therapy with concurrent chemotherapy for non small cell lung cancer”. Cancer, 2011,117(13):3004-13” 

Useful documents, white papers and publications

Learn more about the benefits of proton therapy  and find the latest studies in this IBA white paper.