Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-14T07:23:07.524Z Has data issue: false hasContentIssue false
  • English
  • Français

What are the potential benefits and limitations of particle therapy in the treatment of paediatric malignancies?

Published online by Cambridge University Press:  01 March 2008

P. Hardy  and
P. Bridge
P. Hardy*
Affiliation:
Department of Radiotherapy, Derbyshire Royal Infirmary, London Road, Derby, UK
P. Bridge
Affiliation:
Faculty of Health and Wellbeing, Collegiate Crescent Campus, Sheffield Hallam University, Sheffield, UK
*
Correspondence to: Paul Hardy, Department of Radiotherapy, Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK. E-mail: Paulhardy@hotmail.co.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The reduction in dose received by normal tissue is essential in radiotherapy to reduce the chance of late side-effects. This is especially true in paediatric radiotherapy as any late-effects can seriously impair the future quality of life experienced by the treated child.

Particle therapy uses high-energy particles to deliver a surgically precise beam of energy to a pre-determined position in the body. Common side-effects associated with conventional radiotherapy (CRT) are considerably reduced, often virtually eliminated, owing to the reduction in dose received by neighbouring healthy tissues, improving future quality of life. The superior accuracy of particles also means the dose can be escalated improving control rates.

Clinical trials, reviews and planning studies have been reviewed to assess the benefits and limitations offered by particle therapy in paediatric treatments. The reduced integral dose and improved conformity is clearly highlighted throughout these studies, demonstrating the potential advantages available with particles when treating paediatric patients.

The data suggest that the advantages experienced with particle therapy result in a significant reduction in the side-effects experienced and therefore an improvement in quality of life when compared with conventional therapy. Owing to the reduction of subsequent sequelae, paediatric patients need to be considered when designing and constructing a particle centre in the UK.

Keywords

Paediatric malignancyparticle therapyprotonsradiation side effects
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 7 , Issue 1 , March 2008 , pp. 9 - 18
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Taylor, RE.Paediatric oncology. In: Bomford, CK, Kunkler, IH (eds). Walter and Miller's Textbook of Radiotherapy, 6th edition. Edinburgh: Churchill Livingstone, 2003, pp. 583– 596.Google ScholarPubMed
Souhami, R, Tobias, J.Cancer and its Management, 5th edition.Oxford:Blackwell Publishing 2005, pp. 405–425.Google Scholar
Magnani, C, Aareleid, J, Viscomi, S, Pastore, G, Berrino, F.Variation in survival of children with central nervous system (CNS) malignancies diagnosed in Europe between 1978 and 1992: the EUROCARE study. Eur J Cancer 2001;37:711–721.Google Scholar
University of Minnesota Cancer Center. Last accessed on 14th November 2006 at URL www.cancer.umn.eduGoogle Scholar
Bjork-Eriksson, T, Glimelius, B.The potential of proton beam therapy in paediatric cancer. Acta Oncol 2005;44:871–875.Google Scholar
American Cancer Society, 2007. Last accessed on 4th May 2007 at URL www.cancer.org/downloads/STT/Cancer_Statistics_Combined_2007.ppt#257, 2, US Mortality, 2004.Google Scholar
Halperin, EC.Particle therapy and treatment of cancer. Lancet Oncol 2006;7:676–685.CrossRefGoogle ScholarPubMed
Neglia, JP, Friedman, DL, Yasui, Y. et al. Second malignant neoplasms in five-year survivors of childhood cancer: Childhood Cancer Survivor Study. J Natl Cancer Inst 2001;93 (8):618–629.Google Scholar
Oeffinger, KC, Hudson, MM.Long-term complications following childhood and adolescent cancer: Foundations for providing risk-based health care for survivors. CA Cancer J Clin 2004;54:208–236.Google Scholar
Kiltie, AE, Lashford, LS, Gattamaneni, HR. Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. Med Pediatr Oncol 1997;28:348–354.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Metz, J.Reduced normal tissue toxicity with proton therapy. University of Pennsylvania:Abramson Cancer Center, 2006.Google Scholar
Loeffler, JSSmith, AR, Suit, HD.The potential role of proton beams in radiation oncology. J Clin Oncol 1997;24:686–695.Google ScholarPubMed
Hug, EB, Nevinny-Stikel, M, Fuss, M, Miller, DW, Schaefer, RA, Slater, JD.Conformal proton radiation treatment for retroperitoneal neuroblastoma: introduction of a novel technique. Med Pediatr Oncol 2001;37:36–41.Google Scholar
Jones, B, Burnet, NG.Radiotherapy for the future. Br Med J 2005;330:979–980.Google Scholar
Miralbell, R, Lomax, A, Cella, L, Schneider, U.Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumours. Int J Radiat Oncol Biol Phys 2002;54:824–829.CrossRefGoogle Scholar
Goitein, M, Jermann, M.The relative costs of proton and photon therapy. Clin Oncol 2003;15:S37–S50.Google Scholar
Slater, JD.Clinical applications of proton radiation treatment at Loma Linda University: review of a fifteen-year experience. Technol Cancer Res Treat 2006;5(2):81–89.Google Scholar
Jones, B.The case for particle therapy. Br J Radiol 2006;79:24–31.Google Scholar
Glimelius, B, Ask, A, Bjelkengren, G et al. Number of patients potentially eligible for proton therapy. Acta Oncol 2005;44:836–849.CrossRefGoogle ScholarPubMed
Halperin, EC, Constine, LS, Tarbell, NJ et al. Paediatric Radiation Oncology, 3rd edition.Philadelphia:Lipincott Williams & Wilkins, 1999, pp. 1–586.Google Scholar
Kirsch, DG, Tarbell, NJ.Conformal radiation therapy for childhood CNS tumours. Oncologist 2004;9:442–450.Google Scholar
Mulhern, RK, Palmer, SL.Neurocognitive late effects in paediatric cancer. Curr Probl Cancer 2003;27:177–197.CrossRefGoogle Scholar
Mulhern, RK, Hancock, J, Fairclough, D, Kun, L.Neuropsychological status of children treated for brain tumours: a critical review and integrative analysis. Med Paediatr Oncol 1992;20:181–191.CrossRefGoogle ScholarPubMed
Lin, R, Hug, EB, Schaefer, RA, Miller, DW, Slater, JM, Slater, JD.Conformal proton radiation therapy of the posterior fossa: a study comparing protons with three-dimensional planned photons in limiting dose to auditory structures. Int J Radiat Oncol Biol Phys 2000;48:1219–1226.Google Scholar
Hug, EB, Adams, J, Fitzek, M, De Vries, A, Munzenrider, JE.Fractionated, three-dimensional, planning-assisted Proton-radiation therapy for orbital rhabdomyosarcoma: a novel technique. Int J Radiat Oncol Biol Phys 2000;47 (4): 979–984.Google Scholar
Guyuron, B, Dagys, A, Orth, D.Long-term effects of orbital irradiation. Head Neck Surg 1987;10:85–87.CrossRefGoogle ScholarPubMed
Yock, T, Schneider, R, Friedmann, A, Adams, J, Fullerton, B, Tarbell, N.Proton radiotherapy for orbital rhabdomyosarcoma: clinical outcome and a dosimetric comparison with photons. Int J Radiat Oncol Biol Phys 2005;63:1161–1168.Google Scholar
St Clair, WH, Adams, JA, Bues, M.Advantage of protons compared to conventional X-ray or IMRT in the treatment of a paediatric patient with medulloblastoma. Int J Radiat Oncol Biol Phys 2004;58:727–734.Google Scholar
Miralbell, R, Lomax, A, Russo, M.Potential role of proton therapy in the treatment of paediatric medulloblastoma/primitive neuro-ectodermal tumours: spinal theca irradiation. Int J Radiat Oncol Biol Phys 1997;38(4):805–811.Google Scholar
Livesey, EA, Hindmarsh, PC, Brook, CG, Whitton, AC, Bloom, HJ, Tobias, JS, Godlee, JN, Britton, J.Endocrine disorders following treatment of childhood brain tumours. Br J Cancer 1990;61:622–625.Google Scholar
Lundkvist, J, Ekman, M, Ericsson, SR, Jonsson, B, Glimelius, B.Cost-effectiveness of proton radiation in the treatment of childhood medulloblastoma. Cancer 2005;103:793–801.CrossRefGoogle ScholarPubMed
Hancock, SL, Cox, RSMcDougall, IR.Thyroid diseases after treatment of Hodgkin's disease. N Engl J Med 1991;325:599–605.Google Scholar
Lee, CT, Bilton, SD, Famiglietti, RM et al. Treatment planning with protons for paediatric retinoblastoma, medulloblastoma, and pelvic sarcoma: how do protons compare with other conformal techniques? Int J Radiat Oncol Biol Phys 2005;63 (2):362–372.Google Scholar
Raney, RB, Anderson, JR, Kollath, J.Late effects of therapy in 94 patients with localized rhabdomyosarcoma of the orbit: report from the intergroup rhabdomyosarcoma study (IRS)-III, 1984–1991. Med Paediatr Oncol 2000:417.Google Scholar
Hug, EB, Sweeney, RA, Nurre, PM, Holloway, KC, Slater, JD, Munzenrider, JE.Proton radiotherapy in management of paediatric base of skull tumours. Int J Radiat Oncol Biol Phys 2002;52:1017–1024.Google Scholar
Bhatia, S, Yasui, Y, Robinson, LL.High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin's disease: report from the Late Effects study Group. J Clin Oncol 2003;21:4386–4394.CrossRefGoogle ScholarPubMed
Van Leeuwen, FE, Travis, IB. Second cancers. In:DeVita, VT, Hellman, S, Rosenberg, SA (eds). Cancer: Principles and Practice of Oncology. 6th edition. Philadelphia: Lippincott Williams & Wilkins, 2001, pp. 2939–2964.Google Scholar
Donaldson, S.Lessons from our children. Int J Radiat Oncol Biol Phys 1993;26:739–749.Google Scholar
Ng, AK, Bernardo, MP, Weller, E.Long-term survival and competing causes of death in patients with early-stage Hodgkin's disease treated at age 50 or younger. J Clin Oncol 2002;20:2101–2108.Google Scholar
Kirsch, DG, Ebb, DH, Hernandez, AH, Tarbell, NJ.Proton radiotherapy for Hodgkin's disease in the sacrum. Lancet Oncol 2005;6:532–533.Google Scholar
Suit, HD.Protons to replace photons in external beam radiation therapy? Clin Oncol 2003;15:29–31.CrossRefGoogle ScholarPubMed
Hull, MC, Morris, CG, Pepine, CJ.Valvular dysfunction and carotid, sublevel, and coronary artery disease of Hodgkin lymphoma treated with radiation therapy. JAMA 2003;290:2831–2837.Google Scholar
Sisterton, J.Proton Therapy Co-operative Oncology Group Newsletter. Boston:Massachusetts General Hospital, 2001.Google Scholar
Orecchia, R, Zurlo, A, Loasses, A et al. Particle beam therapy (hadrontherapy): Basis for interest and clinical experience. Eur J Cancer 1998;34(4):459–468.Google Scholar