Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results

The aim of study: to analyze the accumulated experience and try to identify those clinical situations in which the use of protons will be economically and clinically more effective than photon radiation therapy. Material and methods. The articles devoted to the study of the evaluation and comparison...

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Main Authors: O. S. Regentova, O. I. Shcherbenko, E. V. Kumirova, F. F. Antonenko, V. A. Solodkiy
Format: Article
Language:Russian
Published: Russian Academy of Sciences, Tomsk National Research Medical Center 2024-05-01
Series:Сибирский онкологический журнал
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Online Access:https://www.siboncoj.ru/jour/article/view/3046
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author O. S. Regentova
O. I. Shcherbenko
E. V. Kumirova
F. F. Antonenko
V. A. Solodkiy
author_facet O. S. Regentova
O. I. Shcherbenko
E. V. Kumirova
F. F. Antonenko
V. A. Solodkiy
author_sort O. S. Regentova
collection DOAJ
description The aim of study: to analyze the accumulated experience and try to identify those clinical situations in which the use of protons will be economically and clinically more effective than photon radiation therapy. Material and methods. The articles devoted to the study of the evaluation and comparison of the effectiveness of proton and photon radiation beams in the treatment of tumors of the central nervous system and published over the past 25 years were searched in the Medline, Embase and the Cochrane Library databases. Results. the analysis of available publications has shown that accelerated protons do not improve survival rates and disease-free rates in all forms of brain tumors compared with photon therapy. However, protons can significantly increase the level of dose distribution conformity and reduce the dose to critical structures (pituitary gland, cochlea, eye lenses, hypothalamus), thus reducing the risk of hearing and visual impairment as well as hormonal and cognitive disorders. All this is critically important for potentially curable malignant tumors, such as medulloblastoma and germinoma, for low malignant potential tumors (grade 1–2 glioma) or tumors with decreased metastatic potential, since proton therapy compared to photon therapy reduces the risk of late side effects that worsen the quality of life of cured children. Conclusion. central nervous system tumors are one of the most common solid malignant neoplasms in children. Radiation therapy (RT) is recognized as an important therapeutic component of treatment and is often used in strategies for multimodal therapy of tumors of the central nervous system in children. Proton radiation therapy is one of the attractive methods of radiotherapy with minimal dose distribution to normal tissues and a decrease in the absorbed dose. The precision of protons reduces the risk of long-term side effects associated with this type of treatment and the induction of secondary malignancies, which is of particular importance for the quality of life.
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spelling doaj-art-4fe60e3d527f4ffe9e77f5b16312a6aa2025-08-20T03:43:40ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682024-05-012329210010.21294/1814-4861-2024-23-2-92-1001226Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and resultsO. S. Regentova0O. I. Shcherbenko1E. V. Kumirova2F. F. Antonenko3V. A. Solodkiy4Russian Scientific Center of Roentgenoradiology of the Ministry of Health of RussiaRussian Scientific Center of Roentgenoradiology of the Ministry of Health of RussiaRussian Scientific Center of Roentgenoradiology of The Ministry of Health of Russia; Morozov Children’s City Clinical Hospital of The Moscow City, Healthcare Department; N.N. Blokhin National Medical Research Center of Oncology of The Ministry of Health of The Russia; N.I. Pirogov Russian National Research Medical University of The Ministry of Health of RussiaRussian Scientific Center of Roentgenoradiology of the Ministry of Health of RussiaRussian Scientific Center of Roentgenoradiology of the Ministry of Health of RussiaThe aim of study: to analyze the accumulated experience and try to identify those clinical situations in which the use of protons will be economically and clinically more effective than photon radiation therapy. Material and methods. The articles devoted to the study of the evaluation and comparison of the effectiveness of proton and photon radiation beams in the treatment of tumors of the central nervous system and published over the past 25 years were searched in the Medline, Embase and the Cochrane Library databases. Results. the analysis of available publications has shown that accelerated protons do not improve survival rates and disease-free rates in all forms of brain tumors compared with photon therapy. However, protons can significantly increase the level of dose distribution conformity and reduce the dose to critical structures (pituitary gland, cochlea, eye lenses, hypothalamus), thus reducing the risk of hearing and visual impairment as well as hormonal and cognitive disorders. All this is critically important for potentially curable malignant tumors, such as medulloblastoma and germinoma, for low malignant potential tumors (grade 1–2 glioma) or tumors with decreased metastatic potential, since proton therapy compared to photon therapy reduces the risk of late side effects that worsen the quality of life of cured children. Conclusion. central nervous system tumors are one of the most common solid malignant neoplasms in children. Radiation therapy (RT) is recognized as an important therapeutic component of treatment and is often used in strategies for multimodal therapy of tumors of the central nervous system in children. Proton radiation therapy is one of the attractive methods of radiotherapy with minimal dose distribution to normal tissues and a decrease in the absorbed dose. The precision of protons reduces the risk of long-term side effects associated with this type of treatment and the induction of secondary malignancies, which is of particular importance for the quality of life.https://www.siboncoj.ru/jour/article/view/3046brain tumorschildrenaccelerated protonsphoton radiationquality of lifeneurooncologyradiation therapy
spellingShingle O. S. Regentova
O. I. Shcherbenko
E. V. Kumirova
F. F. Antonenko
V. A. Solodkiy
Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
Сибирский онкологический журнал
brain tumors
children
accelerated protons
photon radiation
quality of life
neurooncology
radiation therapy
title Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
title_full Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
title_fullStr Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
title_full_unstemmed Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
title_short Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results
title_sort proton therapy in pediatric neuro oncology potential advantages and the relationship between cost and results
topic brain tumors
children
accelerated protons
photon radiation
quality of life
neurooncology
radiation therapy
url https://www.siboncoj.ru/jour/article/view/3046
work_keys_str_mv AT osregentova protontherapyinpediatricneurooncologypotentialadvantagesandtherelationshipbetweencostandresults
AT oishcherbenko protontherapyinpediatricneurooncologypotentialadvantagesandtherelationshipbetweencostandresults
AT evkumirova protontherapyinpediatricneurooncologypotentialadvantagesandtherelationshipbetweencostandresults
AT ffantonenko protontherapyinpediatricneurooncologypotentialadvantagesandtherelationshipbetweencostandresults
AT vasolodkiy protontherapyinpediatricneurooncologypotentialadvantagesandtherelationshipbetweencostandresults