Details

Autor(en) / Beteiligte

• 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

Titel

Proton Beam Craniospinal Irradiation Reduces Acute Toxicity for Adults With Medulloblastoma

Ist Teil von

• International journal of radiation oncology, biology, physics, 2013-06, Vol.86 (2), p.277-284

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.