Proton versus photon radiotherapy for common pediatric brain tumors: Comparison of models of dose characteristics and their relationship to cognitive function

摘要: Background To determine whether proton radiotherapy has clinical advantages over photon radiotherapy, we modeled the dose characteristics of both to critical normal tissue volumes using data from patients with four types childhood brain tumors. Procedures Three-dimensional imaging and treatment planning data, including targeted tumor tissues contours, were acquired for 40 patients, 10 each optic pathway glioma (OPG), craniopharyngioma (CR), infratentorial ependymoma (EP), or medulloblastoma (MB). Dose–volume collected entire brain, temporal lobes, cochlea, hypothalamus patient. The averaged compared based on modality (protons vs. photons) dose-cognitive effects models. Outcomes estimated 5 years. Results Relatively small such as cochlea may be spared radiation exposure when not adjacent primary volume. Larger supratentorial lobes receive less low intermediate doses. When applied longitudinal models effects, these differences resulted in clinically significant higher IQ scores MB CR academic reading OPG. Extreme between distributions precluded meaningful comparison protons photons EP. Conclusions Differences overall distributions, indicated by modeling changes cognitive function, showed that a reduction lower-dose mean would have long-term, children MB, CR, Pediatr Blood Cancer 2008;51:110–117. © 2008 Wiley-Liss, Inc.