Modern Radiotherapy for Pediatric Brain Tumors
Cancer is a leading cause of death in children with tumors of the central nervous system, the most commonly encountered solid malignancies in this population. Radiotherapy (RT) is an integral part of managing brain tumors, with excellent long-term survival overall. The tumor histology will dictate t...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/6/1533 |
| _version_ | 1797565573688721408 |
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| author | Nicholas J. DeNunzio Torunn I. Yock |
| author_facet | Nicholas J. DeNunzio Torunn I. Yock |
| author_sort | Nicholas J. DeNunzio |
| collection | DOAJ |
| description | Cancer is a leading cause of death in children with tumors of the central nervous system, the most commonly encountered solid malignancies in this population. Radiotherapy (RT) is an integral part of managing brain tumors, with excellent long-term survival overall. The tumor histology will dictate the volume of tissue requiring treatment and the dose. However, radiation in developing children can yield functional deficits and/or cosmetic defects and carries a risk of second tumors. In particular, children receiving RT are at risk for neurocognitive effects, neuroendocrine dysfunction, hearing loss, vascular anomalies and events, and psychosocial dysfunction. The risk of these late effects is directly correlated with the volume of tissue irradiated and dose delivered and is inversely correlated with age. To limit the risk of developing these late effects, improved conformity of radiation to the target volume has come from adopting a volumetric planning process. Radiation beam characteristics have also evolved to achieve this end, as exemplified through development of intensity modulated photons and the use of protons. Understanding dose limits of critical at-risk structures for different RT modalities is evolving. In this review, we discuss the physical basis of the most common RT modalities used to treat pediatric brain tumors (intensity modulated radiation therapy and proton therapy), the RT planning process, survival outcomes for several common pediatric malignant brain tumor histologies, RT-associated toxicities, and steps taken to mitigate the risk of acute and late effects from treatment. |
| first_indexed | 2024-03-10T19:15:04Z |
| format | Article |
| id | doaj.art-7479a80684e84ccdb8a64e34a7e48633 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T19:15:04Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-7479a80684e84ccdb8a64e34a7e486332023-11-20T03:30:38ZengMDPI AGCancers2072-66942020-06-01126153310.3390/cancers12061533Modern Radiotherapy for Pediatric Brain TumorsNicholas J. DeNunzio0Torunn I. Yock1Department of Radiation Oncology, Massachusetts General Hospital/Harvard Medical School, 55 Fruit St, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital/Harvard Medical School, 55 Fruit St, Boston, MA 02114, USACancer is a leading cause of death in children with tumors of the central nervous system, the most commonly encountered solid malignancies in this population. Radiotherapy (RT) is an integral part of managing brain tumors, with excellent long-term survival overall. The tumor histology will dictate the volume of tissue requiring treatment and the dose. However, radiation in developing children can yield functional deficits and/or cosmetic defects and carries a risk of second tumors. In particular, children receiving RT are at risk for neurocognitive effects, neuroendocrine dysfunction, hearing loss, vascular anomalies and events, and psychosocial dysfunction. The risk of these late effects is directly correlated with the volume of tissue irradiated and dose delivered and is inversely correlated with age. To limit the risk of developing these late effects, improved conformity of radiation to the target volume has come from adopting a volumetric planning process. Radiation beam characteristics have also evolved to achieve this end, as exemplified through development of intensity modulated photons and the use of protons. Understanding dose limits of critical at-risk structures for different RT modalities is evolving. In this review, we discuss the physical basis of the most common RT modalities used to treat pediatric brain tumors (intensity modulated radiation therapy and proton therapy), the RT planning process, survival outcomes for several common pediatric malignant brain tumor histologies, RT-associated toxicities, and steps taken to mitigate the risk of acute and late effects from treatment.https://www.mdpi.com/2072-6694/12/6/1533pediatric brain tumorschildhoodradiationradiotherapytreatment planningproton |
| spellingShingle | Nicholas J. DeNunzio Torunn I. Yock Modern Radiotherapy for Pediatric Brain Tumors Cancers pediatric brain tumors childhood radiation radiotherapy treatment planning proton |
| title | Modern Radiotherapy for Pediatric Brain Tumors |
| title_full | Modern Radiotherapy for Pediatric Brain Tumors |
| title_fullStr | Modern Radiotherapy for Pediatric Brain Tumors |
| title_full_unstemmed | Modern Radiotherapy for Pediatric Brain Tumors |
| title_short | Modern Radiotherapy for Pediatric Brain Tumors |
| title_sort | modern radiotherapy for pediatric brain tumors |
| topic | pediatric brain tumors childhood radiation radiotherapy treatment planning proton |
| url | https://www.mdpi.com/2072-6694/12/6/1533 |
| work_keys_str_mv | AT nicholasjdenunzio modernradiotherapyforpediatricbraintumors AT torunniyock modernradiotherapyforpediatricbraintumors |