title: Early clinical outcomes using proton radiation for children with central nervous system atypical teratoid rhabdoid tumors.
abstract: OBJECTIVE
  Atypical teratoid/rhabdoid tumor (AT/RT) is an uncommon and aggressive tumor that often affects infants. Irradiation improves survival but has traditionally been avoided in patients under the age of 3 due to the increasing risk of neurocognitive side effects. We report the first cohort of AT/RT patients treated with proton therapy.
  
  
  METHODS
  All patients with AT/RT treated at Massachusetts General Hospital (MGH) Frances H. Burr Proton Beam Therapy Benter between July 2004 and November 2011 were included in this study. All patients were treated with 3-dimensional conformal proton therapy (3D-CPT).
  
  
  RESULTS
  Ten consecutive patients of a median 2.3 years of age and with a median follow-up of 27.3 months (range, 11.3-99.4 months) were identified. Two patients suffered distant relapse; 1 patient was successfully treated with involved field irradiation and chemotherapy, while the second patient died of disease. At last follow-up, 9 patients were alive without evidence of disease. Proton radiation demonstrated increasing sparing of the cerebrum, temporal lobe, cochlea, and hypothalamus.
  
  
  CONCLUSIONS
  Initial clinical outcomes with proton therapy are favorable. The advantages of proton therapy are particularly suited to the treatment of AT/RT, a tumor that often requires irradiation treatment at an age when avoiding irradiation to healthy tissues is most desirable.
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: De Amorim Bernstein
authors.forename: Roshan
authors.initials: R
authors.lastname: Sethi
authors.forename: Alexei
authors.initials: A
authors.lastname: Trofimov
authors.forename: Chuan
authors.initials: C
authors.lastname: Zeng
authors.forename: Barbara
authors.initials: B
authors.lastname: Fullerton
authors.forename: Beow Y
authors.initials: BY
authors.lastname: Yeap
authors.forename: David
authors.initials: D
authors.lastname: Ebb
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Tarbell
authors.forename: Torunn I
authors.initials: TI
authors.lastname: Yock
authors.forename: Shannon M
authors.initials: SM
authors.lastname: MacDonald
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015192:Infratentorial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods; D061766:Proton Therapy / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D018335:Rhabdoid Tumor / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D015173:Supratentorial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D013724:Teratoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents