Proton beam therapy (PT) in the management of CNS tumors in childhood.
At the Centre de Protontherapie d'Orsay, nine children with intra-cranial malignancies were treated between July 1994 and January 1998. Immediate and late tolerances were excellent in all cases (follow-up 2 to 50 months). Two patients recurred locally (marginal failures), seven are alive and doing well. At Loma Linda, 28 children were treated between 1991 and 1994, 16 for a benign tumor of the brain and twelve for a malignant one. With a follow-up of seven to 49 months, three patients died (grade 2 to 4 gliomas), one is living with a persistent disease. Four children had treatment-related toxicity (one cataract, two hormonal failures and two seizures). The other children are doing well. At MGH Boston, 18 children with skull base-cervical spine chordomas have been reported. At five years, actuarial survival and disease-free survival have been 68 and 63%, respectively. Children with cervical sites had a worse prognosis (p = 0.008). Four children had radiation-related morbidity: two pituitary failures, one temporal lobe necrosis, one temporal muscle fibrosis. In this experience, such rare tumors seemed to behave in children like in adults.
Habrand
J L
JL
Centre de Protonthérapie d'Orsay, France.
Mammar
H
H
Ferrand
R
R
Pontvert
D
D
Bondiau
P Y
PY
Kalifa
C
C
Zucker
J M
JM
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D002817:Chordoma / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D011880:Radiotherapy Planning, Computer-Assisted; D011881:Radiotherapy, Computer-Assisted; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D015996:Survival Rate