Radiation Necrosis and White Matter Lesions in Pediatric Patients With Brain Tumors Treated With Pencil Beam Scanning Proton Therapy.

Bojaxhiu, Beat
Ahlhelm, Frank
Walser, Marc
Placidi, Lorenzo
Kliebsch, Ulrike
Mikroutsikos, Lorentzos
Morach, Petra
Bolsi, Alessandra
Lomax, Tony
Pica, Alessia
Weber, Damien Charles

Open link

Publication date

March 2018

DOI

10.1016/j.ijrobp.2017.11.037

Publisher

Elsevier BV

ISSN

0360-3016

Abstract

PURPOSE To assess the rate of radiation necrosis (RN) and white matter lesions (WMLs) in pediatric patients with primary brain tumors treated with pencil beam scanning (PBS) proton therapy (PT) with or without concomitant chemotherapy at the PSI. METHODS AND MATERIALS Between 1999 and 2015, 171 pediatric patients (age <18 years) were treated with PT. Median age at diagnosis was 3.3 years (range, 0.3-17.0 years), and the median delivered dose was 54 Gy (relative biological effectiveness) (range, 40.0-74.1 Gy). Radiation necrosis and WMLs were defined as a new area of abnormal signal intensity on T2-weighted images or increased signal intensity on T2-weighted images, and contrast enhancement on T1 occurring in the brain parenchyma in...