Proton Beam Therapy for Children With Neuroblastoma
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Proton Beam Therapy for Children With Neuroblastoma : Experiences From the Prospective KiProReg Registry. / Jazmati, Danny; Butzer, Sarina; Hero, Barbara; Ahmad Khalil, Dalia; Merta, Julien; Bäumer, Christian; Plum, Gina; Fuchs, Jörg; Koerber, Friederike; Steinmeier, Theresa; Peters, Sarah; Doyen, Jerome; Thole, Theresa; Schmidt, Matthias; Blase, Christoph; Tippelt, Stephan; Eggert, Angelika; Schwarz, Rudolf; Simon, Thorsten; Timmermann, Beate.
In: FRONT ONCOL, Vol. 10, 2020, p. 617506.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Proton Beam Therapy for Children With Neuroblastoma
T2 - Experiences From the Prospective KiProReg Registry
AU - Jazmati, Danny
AU - Butzer, Sarina
AU - Hero, Barbara
AU - Ahmad Khalil, Dalia
AU - Merta, Julien
AU - Bäumer, Christian
AU - Plum, Gina
AU - Fuchs, Jörg
AU - Koerber, Friederike
AU - Steinmeier, Theresa
AU - Peters, Sarah
AU - Doyen, Jerome
AU - Thole, Theresa
AU - Schmidt, Matthias
AU - Blase, Christoph
AU - Tippelt, Stephan
AU - Eggert, Angelika
AU - Schwarz, Rudolf
AU - Simon, Thorsten
AU - Timmermann, Beate
N1 - Copyright © 2021 Jazmati, Butzer, Hero, Ahmad Khalil, Merta, Bäumer, Plum, Fuchs, Koerber, Steinmeier, Peters, Doyen, Thole, Schmidt, Blase, Tippelt, Eggert, Schwarz, Simon and Timmermann.
PY - 2020
Y1 - 2020
N2 - Objective: Radiotherapy (RT) is an integral part of the interdisciplinary treatment of patients with high-risk neuroblastoma (NB). With the continuous improvements of outcome, the interest in local treatment strategies that reduce treatment-related side effects while achieving optimal oncological results is growing. Proton beam therapy (PBT) represents a promising alternative to conventional photon irradiation with regard to the reduction of treatment burden.Method: Retrospective analysis of children with high or intermediate risk NB receiving PBT of the primary tumor site during first-line therapy between 2015 and 2020 was performed. Data from the prospective in-house registry Standard Protonentherapie WPE - Kinder- (KiProReg) with respect to tumor control and treatment toxicity were analyzed. Adverse events were classified according to CTCAE Version 4 (V4.0) before, during, and after PBT.Results: In total, 44 patients (24 male, 20 female) with high (n = 39) or intermediate risk NB (n = 5) were included in the analysis. Median age was 3.4 years (range, 1.4-9.9 years). PBT doses ranged from 21.0 to 39.6 Gray (Gy) (median 36.0 Gy). Five patients received PBT to the MIBG-avid residual at the primary tumor site at time of PBT according to the NB-2004 protocol. In 39 patients radiation was given to the pre-operative tumor bed with or without an additional boost in case of residual tumor. After a median follow-up (FU) of 27.6 months, eight patients developed progression, either local recurrence (n = 1) or distant metastases (n = 7). Four patients died due to tumor progression. At three years, the estimated local control, distant metastatic free survival, progression free survival, and overall survival was 97.7, 84.1, 81.8, and 90.9%, respectively. During radiation, seven patients experienced higher-grade (CTCAE ≥ °3) hematologic toxicity. No other higher grade acute toxicity occurred. After PBT, one patient developed transient myelitis while receiving immunotherapy. No higher grade long-term toxicity was observed up to date.Conclusion: PBT was a well tolerated and effective local treatment in children with high and intermediate risk NB. The role of RT in an intensive multidisciplinary treatment regimen remains to be studied in the future in order to better define timing, doses, target volumes, and general need for RT in a particularly sensitive cohort of patients.
AB - Objective: Radiotherapy (RT) is an integral part of the interdisciplinary treatment of patients with high-risk neuroblastoma (NB). With the continuous improvements of outcome, the interest in local treatment strategies that reduce treatment-related side effects while achieving optimal oncological results is growing. Proton beam therapy (PBT) represents a promising alternative to conventional photon irradiation with regard to the reduction of treatment burden.Method: Retrospective analysis of children with high or intermediate risk NB receiving PBT of the primary tumor site during first-line therapy between 2015 and 2020 was performed. Data from the prospective in-house registry Standard Protonentherapie WPE - Kinder- (KiProReg) with respect to tumor control and treatment toxicity were analyzed. Adverse events were classified according to CTCAE Version 4 (V4.0) before, during, and after PBT.Results: In total, 44 patients (24 male, 20 female) with high (n = 39) or intermediate risk NB (n = 5) were included in the analysis. Median age was 3.4 years (range, 1.4-9.9 years). PBT doses ranged from 21.0 to 39.6 Gray (Gy) (median 36.0 Gy). Five patients received PBT to the MIBG-avid residual at the primary tumor site at time of PBT according to the NB-2004 protocol. In 39 patients radiation was given to the pre-operative tumor bed with or without an additional boost in case of residual tumor. After a median follow-up (FU) of 27.6 months, eight patients developed progression, either local recurrence (n = 1) or distant metastases (n = 7). Four patients died due to tumor progression. At three years, the estimated local control, distant metastatic free survival, progression free survival, and overall survival was 97.7, 84.1, 81.8, and 90.9%, respectively. During radiation, seven patients experienced higher-grade (CTCAE ≥ °3) hematologic toxicity. No other higher grade acute toxicity occurred. After PBT, one patient developed transient myelitis while receiving immunotherapy. No higher grade long-term toxicity was observed up to date.Conclusion: PBT was a well tolerated and effective local treatment in children with high and intermediate risk NB. The role of RT in an intensive multidisciplinary treatment regimen remains to be studied in the future in order to better define timing, doses, target volumes, and general need for RT in a particularly sensitive cohort of patients.
U2 - 10.3389/fonc.2020.617506
DO - 10.3389/fonc.2020.617506
M3 - SCORING: Journal article
C2 - 33552991
VL - 10
SP - 617506
JO - FRONT ONCOL
JF - FRONT ONCOL
SN - 2234-943X
ER -