Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma
Purpose Efficacy and acute toxicity of proton craniospinal irradiation (p-CSI) were compared with conventional photon CSI (x-CSI) for adults with medulloblastoma. Methods and Materials Forty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anders...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2013-06, Vol.86 (2), p.277-284 |
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| creator | Brown, Aaron P., MD Barney, Christian L., BS Grosshans, David R., MD, PhD McAleer, Mary Frances, MD, PhD de Groot, John F., MD Puduvalli, Vinay K., MD Tucker, Susan L., PhD Crawford, Cody N., CMD Khan, Meena, CMD Khatua, Soumen, MD Gilbert, Mark R., MD Brown, Paul D., MD Mahajan, Anita, MD |
| description | Purpose Efficacy and acute toxicity of proton craniospinal irradiation (p-CSI) were compared with conventional photon CSI (x-CSI) for adults with medulloblastoma. Methods and Materials Forty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anderson Cancer Center from 2003 to 2011 were retrospectively reviewed. Median CSI and total doses were 30.6 and 54 Gy, respectively. The median follow-up was 57 months (range 4-103) for x-CSI patients and 26 months (range 11-63) for p-CSI. Results p-CSI patients lost less weight than x-CSI patients (1.2% vs 5.8%; P =.004), and less p-CSI patients had >5% weight loss compared with x-CSI (16% vs 64%; P =.004). p-CSI patients experienced less grade 2 nausea and vomiting compared with x-CSI (26% vs 71%; P =.004). Patients treated with x-CSI were more likely to have medical management of esophagitis than p-CSI patients (57% vs 5%, P |
| doi_str_mv | 10.1016/j.ijrobp.2013.01.014 |
| format | Article |
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Methods and Materials Forty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anderson Cancer Center from 2003 to 2011 were retrospectively reviewed. Median CSI and total doses were 30.6 and 54 Gy, respectively. The median follow-up was 57 months (range 4-103) for x-CSI patients and 26 months (range 11-63) for p-CSI. Results p-CSI patients lost less weight than x-CSI patients (1.2% vs 5.8%; P =.004), and less p-CSI patients had >5% weight loss compared with x-CSI (16% vs 64%; P =.004). p-CSI patients experienced less grade 2 nausea and vomiting compared with x-CSI (26% vs 71%; P =.004). Patients treated with x-CSI were more likely to have medical management of esophagitis than p-CSI patients (57% vs 5%, P <.001). p-CSI patients had a smaller reduction in peripheral white blood cells, hemoglobin, and platelets compared with x-CSI (white blood cells 46% vs 55%, P =.04; hemoglobin 88% vs 97%, P =.009; platelets 48% vs 65%, P =.05). Mean vertebral doses were significantly associated with reductions in blood counts. Conclusions This report is the first analysis of clinical outcomes for adult medulloblastoma patients treated with p-CSI. Patients treated with p-CSI experienced less treatment-related morbidity including fewer acute gastrointestinal and hematologic toxicities.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2013.01.014</identifier><identifier>PMID: 23433794</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute toxicity ; Adolescent ; Adult ; BLOOD CELLS ; BLOOD COUNT ; Cerebellar Neoplasms - blood ; Cerebellar Neoplasms - radiotherapy ; Cranial Irradiation - adverse effects ; Cranial Irradiation - methods ; DISEASE INCIDENCE ; Esophagitis - etiology ; Female ; Hematology, Oncology and Palliative Medicine ; HEMOGLOBIN ; Humans ; IRRADIATION ; Male ; Medulloblastoma - blood ; Medulloblastoma - radiotherapy ; Middle Aged ; NAUSEA ; Nausea - etiology ; NEOPLASMS ; PATIENTS ; Photons - adverse effects ; Photons - therapeutic use ; PROTON BEAMS ; Proton Therapy - adverse effects ; Proton Therapy - methods ; RADIATION DOSES ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Retrospective Studies ; REVIEWS ; Spine - radiation effects ; TOXICITY ; Treatment Outcome ; VOMITING ; Vomiting - etiology ; Weight Loss ; Young Adult</subject><ispartof>International journal of radiation oncology, biology, physics, 2013-06, Vol.86 (2), p.277-284</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>2013 Elsevier Inc. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c579t-2c7824f78fc28e0364028c36b8e4387fa0471347690bd235b178932a22a1adfa3</citedby><cites>FETCH-LOGICAL-c579t-2c7824f78fc28e0364028c36b8e4387fa0471347690bd235b178932a22a1adfa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301613000771$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23433794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22224472$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Brown, Aaron P., MD</creatorcontrib><creatorcontrib>Barney, Christian L., BS</creatorcontrib><creatorcontrib>Grosshans, David R., MD, PhD</creatorcontrib><creatorcontrib>McAleer, Mary Frances, MD, PhD</creatorcontrib><creatorcontrib>de Groot, John F., MD</creatorcontrib><creatorcontrib>Puduvalli, Vinay K., MD</creatorcontrib><creatorcontrib>Tucker, Susan L., PhD</creatorcontrib><creatorcontrib>Crawford, Cody N., CMD</creatorcontrib><creatorcontrib>Khan, Meena, CMD</creatorcontrib><creatorcontrib>Khatua, Soumen, MD</creatorcontrib><creatorcontrib>Gilbert, Mark R., MD</creatorcontrib><creatorcontrib>Brown, Paul D., MD</creatorcontrib><creatorcontrib>Mahajan, Anita, MD</creatorcontrib><title>Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose Efficacy and acute toxicity of proton craniospinal irradiation (p-CSI) were compared with conventional photon CSI (x-CSI) for adults with medulloblastoma. Methods and Materials Forty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anderson Cancer Center from 2003 to 2011 were retrospectively reviewed. Median CSI and total doses were 30.6 and 54 Gy, respectively. The median follow-up was 57 months (range 4-103) for x-CSI patients and 26 months (range 11-63) for p-CSI. Results p-CSI patients lost less weight than x-CSI patients (1.2% vs 5.8%; P =.004), and less p-CSI patients had >5% weight loss compared with x-CSI (16% vs 64%; P =.004). p-CSI patients experienced less grade 2 nausea and vomiting compared with x-CSI (26% vs 71%; P =.004). Patients treated with x-CSI were more likely to have medical management of esophagitis than p-CSI patients (57% vs 5%, P <.001). p-CSI patients had a smaller reduction in peripheral white blood cells, hemoglobin, and platelets compared with x-CSI (white blood cells 46% vs 55%, P =.04; hemoglobin 88% vs 97%, P =.009; platelets 48% vs 65%, P =.05). Mean vertebral doses were significantly associated with reductions in blood counts. Conclusions This report is the first analysis of clinical outcomes for adult medulloblastoma patients treated with p-CSI. Patients treated with p-CSI experienced less treatment-related morbidity including fewer acute gastrointestinal and hematologic toxicities.</description><subject>Acute toxicity</subject><subject>Adolescent</subject><subject>Adult</subject><subject>BLOOD CELLS</subject><subject>BLOOD COUNT</subject><subject>Cerebellar Neoplasms - blood</subject><subject>Cerebellar Neoplasms - radiotherapy</subject><subject>Cranial Irradiation - adverse effects</subject><subject>Cranial Irradiation - methods</subject><subject>DISEASE INCIDENCE</subject><subject>Esophagitis - etiology</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>HEMOGLOBIN</subject><subject>Humans</subject><subject>IRRADIATION</subject><subject>Male</subject><subject>Medulloblastoma - blood</subject><subject>Medulloblastoma - radiotherapy</subject><subject>Middle Aged</subject><subject>NAUSEA</subject><subject>Nausea - etiology</subject><subject>NEOPLASMS</subject><subject>PATIENTS</subject><subject>Photons - adverse effects</subject><subject>Photons - therapeutic use</subject><subject>PROTON BEAMS</subject><subject>Proton Therapy - adverse effects</subject><subject>Proton Therapy - methods</subject><subject>RADIATION DOSES</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted</subject><subject>Retrospective Studies</subject><subject>REVIEWS</subject><subject>Spine - radiation effects</subject><subject>TOXICITY</subject><subject>Treatment Outcome</subject><subject>VOMITING</subject><subject>Vomiting - etiology</subject><subject>Weight Loss</subject><subject>Young Adult</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUl2L1DAUDaK44-o_ECn44kvHfLVpX4Rx0HVhRdEVBR9Cmt46qWkyJumy8-9NmXX9eDFcyMM9OfecnIvQY4LXBJP6-bg2Y_Ddfk0xYWtMcvE7aEUa0Zasqr7cRSvMalyyDD5BD2IcMcaECH4fnVDGGRMtX6Gv74NP3hUvQU3FNihnfNwbp2xxHoLqjUomdz9AP2uIxUbPCYpLf220SYdi8KHY9LNNsfhs0q54m2HW-s6qmPykHqJ7g7IRHt3cp-jT61eX2zflxbuz8-3motSVaFNJtWgoH0QzaNpA1swxbTSruwY4a8SgMBeEcVG3uOspqzoimpZRRakiqh8UO0Uvjrz7uZug1-BSUFbug5lUOEivjPy748xOfvNXkrUV5wJngqdHAh-TkTF7A73T3jnQSdJ8Mopm1LObMcH_mCEmOZmowVrlwM9REt7SmhBWtxnKj1AdfIwBhlsxBMslPTnKY3pySU9ikovnZ0_-NHL76Fdcv51C_s4rA2ERC05Db8KitffmfxP-JdDWOKOV_Q4HiKOfQ84-e5GRSiw_Lhu0LBBheXlEjuEnjoPCWw</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Brown, Aaron P., MD</creator><creator>Barney, Christian L., BS</creator><creator>Grosshans, David R., MD, PhD</creator><creator>McAleer, Mary Frances, MD, PhD</creator><creator>de Groot, John F., MD</creator><creator>Puduvalli, Vinay K., MD</creator><creator>Tucker, Susan L., PhD</creator><creator>Crawford, Cody N., CMD</creator><creator>Khan, Meena, CMD</creator><creator>Khatua, Soumen, MD</creator><creator>Gilbert, Mark R., MD</creator><creator>Brown, Paul D., MD</creator><creator>Mahajan, Anita, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope><scope>5PM</scope></search><sort><creationdate>20130601</creationdate><title>Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma</title><author>Brown, Aaron P., MD ; Barney, Christian L., BS ; Grosshans, David R., MD, PhD ; McAleer, Mary Frances, MD, PhD ; de Groot, John F., MD ; Puduvalli, Vinay K., MD ; Tucker, Susan L., PhD ; Crawford, Cody N., CMD ; Khan, Meena, CMD ; Khatua, Soumen, MD ; Gilbert, Mark R., MD ; Brown, Paul D., MD ; Mahajan, Anita, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c579t-2c7824f78fc28e0364028c36b8e4387fa0471347690bd235b178932a22a1adfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute toxicity</topic><topic>Adolescent</topic><topic>Adult</topic><topic>BLOOD CELLS</topic><topic>BLOOD COUNT</topic><topic>Cerebellar Neoplasms - blood</topic><topic>Cerebellar Neoplasms - radiotherapy</topic><topic>Cranial Irradiation - adverse effects</topic><topic>Cranial Irradiation - methods</topic><topic>DISEASE INCIDENCE</topic><topic>Esophagitis - etiology</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>HEMOGLOBIN</topic><topic>Humans</topic><topic>IRRADIATION</topic><topic>Male</topic><topic>Medulloblastoma - blood</topic><topic>Medulloblastoma - radiotherapy</topic><topic>Middle Aged</topic><topic>NAUSEA</topic><topic>Nausea - etiology</topic><topic>NEOPLASMS</topic><topic>PATIENTS</topic><topic>Photons - adverse effects</topic><topic>Photons - therapeutic use</topic><topic>PROTON BEAMS</topic><topic>Proton Therapy - adverse effects</topic><topic>Proton Therapy - methods</topic><topic>RADIATION DOSES</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted</topic><topic>Retrospective Studies</topic><topic>REVIEWS</topic><topic>Spine - radiation effects</topic><topic>TOXICITY</topic><topic>Treatment Outcome</topic><topic>VOMITING</topic><topic>Vomiting - etiology</topic><topic>Weight Loss</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brown, Aaron P., MD</creatorcontrib><creatorcontrib>Barney, Christian L., BS</creatorcontrib><creatorcontrib>Grosshans, David R., MD, PhD</creatorcontrib><creatorcontrib>McAleer, Mary Frances, MD, PhD</creatorcontrib><creatorcontrib>de Groot, John F., MD</creatorcontrib><creatorcontrib>Puduvalli, Vinay K., MD</creatorcontrib><creatorcontrib>Tucker, Susan L., PhD</creatorcontrib><creatorcontrib>Crawford, Cody N., CMD</creatorcontrib><creatorcontrib>Khan, Meena, CMD</creatorcontrib><creatorcontrib>Khatua, Soumen, MD</creatorcontrib><creatorcontrib>Gilbert, Mark R., MD</creatorcontrib><creatorcontrib>Brown, Paul D., MD</creatorcontrib><creatorcontrib>Mahajan, Anita, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brown, Aaron P., MD</au><au>Barney, Christian L., BS</au><au>Grosshans, David R., MD, PhD</au><au>McAleer, Mary Frances, MD, PhD</au><au>de Groot, John F., MD</au><au>Puduvalli, Vinay K., MD</au><au>Tucker, Susan L., PhD</au><au>Crawford, Cody N., CMD</au><au>Khan, Meena, CMD</au><au>Khatua, Soumen, MD</au><au>Gilbert, Mark R., MD</au><au>Brown, Paul D., MD</au><au>Mahajan, Anita, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>86</volume><issue>2</issue><spage>277</spage><epage>284</epage><pages>277-284</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose Efficacy and acute toxicity of proton craniospinal irradiation (p-CSI) were compared with conventional photon CSI (x-CSI) for adults with medulloblastoma. Methods and Materials Forty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anderson Cancer Center from 2003 to 2011 were retrospectively reviewed. Median CSI and total doses were 30.6 and 54 Gy, respectively. The median follow-up was 57 months (range 4-103) for x-CSI patients and 26 months (range 11-63) for p-CSI. Results p-CSI patients lost less weight than x-CSI patients (1.2% vs 5.8%; P =.004), and less p-CSI patients had >5% weight loss compared with x-CSI (16% vs 64%; P =.004). p-CSI patients experienced less grade 2 nausea and vomiting compared with x-CSI (26% vs 71%; P =.004). Patients treated with x-CSI were more likely to have medical management of esophagitis than p-CSI patients (57% vs 5%, P <.001). p-CSI patients had a smaller reduction in peripheral white blood cells, hemoglobin, and platelets compared with x-CSI (white blood cells 46% vs 55%, P =.04; hemoglobin 88% vs 97%, P =.009; platelets 48% vs 65%, P =.05). Mean vertebral doses were significantly associated with reductions in blood counts. Conclusions This report is the first analysis of clinical outcomes for adult medulloblastoma patients treated with p-CSI. Patients treated with p-CSI experienced less treatment-related morbidity including fewer acute gastrointestinal and hematologic toxicities.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23433794</pmid><doi>10.1016/j.ijrobp.2013.01.014</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2013-06, Vol.86 (2), p.277-284 |
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| subjects | Acute toxicity Adolescent Adult BLOOD CELLS BLOOD COUNT Cerebellar Neoplasms - blood Cerebellar Neoplasms - radiotherapy Cranial Irradiation - adverse effects Cranial Irradiation - methods DISEASE INCIDENCE Esophagitis - etiology Female Hematology, Oncology and Palliative Medicine HEMOGLOBIN Humans IRRADIATION Male Medulloblastoma - blood Medulloblastoma - radiotherapy Middle Aged NAUSEA Nausea - etiology NEOPLASMS PATIENTS Photons - adverse effects Photons - therapeutic use PROTON BEAMS Proton Therapy - adverse effects Proton Therapy - methods RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Retrospective Studies REVIEWS Spine - radiation effects TOXICITY Treatment Outcome VOMITING Vomiting - etiology Weight Loss Young Adult |
| title | Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma |
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