Proton therapy for pediatric diencephalic tumors

Diencephalic tumors tend to be low grade tumors located near several critical structures, including the optic nerves, optic chiasm, pituitary, hypothalamus, Circle of Willis, and hippocampi. In children, damage to these structures can impact physical and cognitive development over time. Thus, the go...

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Main Authors: Adam J. Grippin, Susan L. McGovern
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2023.1123082/full
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author Adam J. Grippin
Susan L. McGovern
author_facet Adam J. Grippin
Susan L. McGovern
author_sort Adam J. Grippin
collection DOAJ
description Diencephalic tumors tend to be low grade tumors located near several critical structures, including the optic nerves, optic chiasm, pituitary, hypothalamus, Circle of Willis, and hippocampi. In children, damage to these structures can impact physical and cognitive development over time. Thus, the goal of radiotherapy is to maximize long term survival while minimizing late effects, including endocrine disruption leading to precocious puberty, height loss, hypogonadotropic hypogonadism, and primary amenorrhea; visual disruption including blindness; and vascular damage resulting in cerebral vasculopathy. Compared to photon therapy, proton therapy offers the potential to decrease unnecessary dose to these critical structures while maintaining adequate dose to the tumor. In this article, we review the acute and chronic toxicities associated with radiation for pediatric diencephalic tumors, focusing on the use of proton therapy to minimize treatment-related morbidity. Emerging strategies to further reduce radiation dose to critical structures will also be considered.
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spelling doaj.art-2630f5bd2b52450ab327e679c07ebf802023-05-05T06:00:03ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11230821123082Proton therapy for pediatric diencephalic tumorsAdam J. GrippinSusan L. McGovernDiencephalic tumors tend to be low grade tumors located near several critical structures, including the optic nerves, optic chiasm, pituitary, hypothalamus, Circle of Willis, and hippocampi. In children, damage to these structures can impact physical and cognitive development over time. Thus, the goal of radiotherapy is to maximize long term survival while minimizing late effects, including endocrine disruption leading to precocious puberty, height loss, hypogonadotropic hypogonadism, and primary amenorrhea; visual disruption including blindness; and vascular damage resulting in cerebral vasculopathy. Compared to photon therapy, proton therapy offers the potential to decrease unnecessary dose to these critical structures while maintaining adequate dose to the tumor. In this article, we review the acute and chronic toxicities associated with radiation for pediatric diencephalic tumors, focusing on the use of proton therapy to minimize treatment-related morbidity. Emerging strategies to further reduce radiation dose to critical structures will also be considered.https://www.frontiersin.org/articles/10.3389/fonc.2023.1123082/fullpediatric brain tumordiencephalonradiationcraniopharyngiomalow grade gliomapituitary adenoma
spellingShingle Adam J. Grippin
Susan L. McGovern
Proton therapy for pediatric diencephalic tumors
Frontiers in Oncology
pediatric brain tumor
diencephalon
radiation
craniopharyngioma
low grade glioma
pituitary adenoma
title Proton therapy for pediatric diencephalic tumors
title_full Proton therapy for pediatric diencephalic tumors
title_fullStr Proton therapy for pediatric diencephalic tumors
title_full_unstemmed Proton therapy for pediatric diencephalic tumors
title_short Proton therapy for pediatric diencephalic tumors
title_sort proton therapy for pediatric diencephalic tumors
topic pediatric brain tumor
diencephalon
radiation
craniopharyngioma
low grade glioma
pituitary adenoma
url https://www.frontiersin.org/articles/10.3389/fonc.2023.1123082/full
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