Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries
Purpose: To test our hypothesis that, for young children with intracranial tumors, proton radiotherapy in a high-income country does not reduce the risk of a fatal subsequent malignant neoplasm (SMN) compared with photon radiotherapy in low- and middle-income countries. Materials and Methods: We ret...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Particle Therapy Co-operative Group
2021-02-01
|
Series: | International Journal of Particle Therapy |
Subjects: | |
Online Access: | https://theijpt.org/doi/pdf/10.14338/IJPT-20-00041.1 |
id |
doaj-6ce1f0d38f3d43bc86f58430a021f7bc |
---|---|
record_format |
Article |
spelling |
doaj-6ce1f0d38f3d43bc86f58430a021f7bc2021-04-05T16:18:46ZengParticle Therapy Co-operative GroupInternational Journal of Particle Therapy2331-51802021-02-017411010.14338/IJPT-20-00041.12331-5180-7-4-1Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income CountriesKyle J. Gallagher, PhD0Bassem Youssef, MD1Rola Georges, MS, CMD2Anita Mahajan, MD3Joelle Ann Feghali, MS4Racile Nabha, MS5Zeina Ayoub, MD6Wassim Jalbout, PhD7Phillip J. Taddei, PhD8Oregon Health and Science University, Portland, OR, USAAmerican University of Beirut Medical Center, Beirut, LebanonUniversity of Texas MD Anderson Cancer Center, Houston, TX, USARadiation Oncology Department, Mayo Clinic, Rochester, MN, USAAmerican University of Beirut Medical Center, Beirut, LebanonAmerican University of Beirut Medical Center, Beirut, LebanonAmerican University of Beirut Medical Center, Beirut, LebanonAmerican University of Beirut Medical Center, Beirut, LebanonAmerican University of Beirut Medical Center, Beirut, LebanonPurpose: To test our hypothesis that, for young children with intracranial tumors, proton radiotherapy in a high-income country does not reduce the risk of a fatal subsequent malignant neoplasm (SMN) compared with photon radiotherapy in low- and middle-income countries. Materials and Methods: We retrospectively selected 9 pediatric patients with low-grade brain tumors who were treated with 3-dimensional conformal radiation therapy in lowand middle-income countries. Images and contours were deidentified and transferred to a high-income country proton therapy center. Clinically commissioned treatment planning systems of each academic hospital were used to calculate absorbed dose from the therapeutic fields. After fusing supplemental computational phantoms to the patients’ anatomies, models from the literature were applied to calculate stray radiation doses. Equivalent doses were determined in organs and tissues at risk of SMNs, and the lifetime attributable risk of SMN mortality (LAR) was predicted using a dose-effect model. Our hypothesis test was based on the average of the ratios of LARs from proton therapy to that of photon therapy (RLAR)(H0: RLAR = 1; HA: RLAR < 1). Results: Proton therapy reduced the equivalent dose in organs at risk for SMNs and LARs compared with photon therapy for which the RLAR for the cohort was 0.69 ± 0.10, resulting in the rejection of H0 (P < .001, α = 0.05). We observed that the younger children in the cohort (2–4 years old) were at a factor of approximately 2.5 higher LAR compared with the older children (8–12 years old). Conclusion: Our findings suggest that proton radiotherapy has the strong potential of reducing the risk of fatal SMNs in pediatric patients with intracranial tumors if it were made available globally.https://theijpt.org/doi/pdf/10.14338/IJPT-20-00041.1pediatric proton therapyintracranial tumorssecondary malignanciesglobal oncologylow- and middle-income countries |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kyle J. Gallagher, PhD Bassem Youssef, MD Rola Georges, MS, CMD Anita Mahajan, MD Joelle Ann Feghali, MS Racile Nabha, MS Zeina Ayoub, MD Wassim Jalbout, PhD Phillip J. Taddei, PhD |
spellingShingle |
Kyle J. Gallagher, PhD Bassem Youssef, MD Rola Georges, MS, CMD Anita Mahajan, MD Joelle Ann Feghali, MS Racile Nabha, MS Zeina Ayoub, MD Wassim Jalbout, PhD Phillip J. Taddei, PhD Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries International Journal of Particle Therapy pediatric proton therapy intracranial tumors secondary malignancies global oncology low- and middle-income countries |
author_facet |
Kyle J. Gallagher, PhD Bassem Youssef, MD Rola Georges, MS, CMD Anita Mahajan, MD Joelle Ann Feghali, MS Racile Nabha, MS Zeina Ayoub, MD Wassim Jalbout, PhD Phillip J. Taddei, PhD |
author_sort |
Kyle J. Gallagher, PhD |
title |
Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries |
title_short |
Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries |
title_full |
Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries |
title_fullStr |
Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries |
title_full_unstemmed |
Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Lowand Middle-Income Countries |
title_sort |
proton radiotherapy could reduce the risk of fatal second cancers for children with intracranial tumors in lowand middle-income countries |
publisher |
Particle Therapy Co-operative Group |
series |
International Journal of Particle Therapy |
issn |
2331-5180 |
publishDate |
2021-02-01 |
description |
Purpose: To test our hypothesis that, for young children with intracranial tumors, proton radiotherapy in a high-income country does not reduce the risk of a fatal subsequent malignant neoplasm (SMN) compared with photon radiotherapy in low- and middle-income countries.
Materials and Methods: We retrospectively selected 9 pediatric patients with low-grade brain tumors who were treated with 3-dimensional conformal radiation therapy in lowand middle-income countries. Images and contours were deidentified and transferred to a high-income country proton therapy center. Clinically commissioned treatment planning systems of each academic hospital were used to calculate absorbed dose from the therapeutic fields. After fusing supplemental computational phantoms to the patients’ anatomies, models from the literature were applied to calculate stray radiation doses. Equivalent doses were determined in organs and tissues at risk of SMNs, and the lifetime attributable risk of SMN mortality (LAR) was predicted using a dose-effect model. Our hypothesis test was based on the average of the ratios of LARs from proton therapy to that of photon therapy (RLAR)(H0: RLAR = 1; HA: RLAR < 1).
Results: Proton therapy reduced the equivalent dose in organs at risk for SMNs and LARs compared with photon therapy for which the RLAR for the cohort was 0.69 ± 0.10, resulting in the rejection of H0 (P < .001, α = 0.05). We observed that the younger children in the cohort (2–4 years old) were at a factor of approximately 2.5 higher LAR compared with the older children (8–12 years old).
Conclusion: Our findings suggest that proton radiotherapy has the strong potential of reducing the risk of fatal SMNs in pediatric patients with intracranial tumors if it were made available globally. |
topic |
pediatric proton therapy intracranial tumors secondary malignancies global oncology low- and middle-income countries |
url |
https://theijpt.org/doi/pdf/10.14338/IJPT-20-00041.1 |
work_keys_str_mv |
AT kylejgallagherphd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT bassemyoussefmd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT rolageorgesmscmd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT anitamahajanmd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT joelleannfeghalims protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT racilenabhams protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT zeinaayoubmd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT wassimjalboutphd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries AT phillipjtaddeiphd protonradiotherapycouldreducetheriskoffatalsecondcancersforchildrenwithintracranialtumorsinlowandmiddleincomecountries |
_version_ |
1721540725730967552 |